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Emergencies in pediatric cancer patients

Authors
Dean A Lee, MD, PhD
Judith Margolin, MD
Section Editor
David G Poplack, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Children with cancer are at increased risk for life-threatening complications either due to their malignancy or its treatment. Although close monitoring of pediatric cancer patients allows pediatric oncologists to recognize and manage many potential complications before they become emergencies, some emergencies will develop acutely and require initial diagnosis and management by emergency department clinicians or primary care providers. Early recognition, evaluation, and treatment of these potentially serious and at times life-threatening events are important to reduce morbidity and mortality in pediatric cancer patients [1].

The more common emergencies seen in children with cancer will be reviewed here. Signs and symptoms that childhood cancer share with other pediatric illnesses at presentation are discussed separately. (See "Clinical assessment of the child with suspected cancer".)

INFECTION AND FEVER

Pediatric cancer patients are at risk for serious infection because of their impaired immune response, particularly during periods of neutropenia. In these patients, fever is the most common and often the first manifestation of a life-threatening infection, such as septic shock. (See "Systemic inflammatory response syndrome (SIRS) and sepsis in children: Definitions, epidemiology, clinical manifestations, and diagnosis".)

At initial diagnosis, pediatric cancer patients often present with fever due to an infection as a consequence of their underlying malignancies that impair their immunologic response. (See "Clinical assessment of the child with suspected cancer", section on 'Fever'.)

Later during treatment, pediatric cancer patients may also present with fever due to an infection as a consequence of chemotherapy-induced neutropenia. The evaluation, etiology, and treatment of the pediatric child with fever and chemotherapy-induced neutropenia are discussed in detail elsewhere. (See "Fever in children with chemotherapy-induced neutropenia".)

                                        

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Literature review current through: Nov 2016. | This topic last updated: Fri Jun 19 00:00:00 GMT+00:00 2015.
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