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Inicio Enfermedades Infecciosas y Microbiología Clínica Valoración inicial del paciente neutropénico con fiebre: cuantificación del r...
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Vol. 23. Issue S5.
Infecciones en pacientes neutropénicos
Pages 19-23 (December 2005)
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Vol. 23. Issue S5.
Infecciones en pacientes neutropénicos
Pages 19-23 (December 2005)
Infecciones en pacientes neutropénicos
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Valoración inicial del paciente neutropénico con fiebre: cuantificación del riesgo
Initial evaluation of febrile neutropenic patients: risk quantification
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Lourdes Vázqueza,
Corresponding author
lvazlo@usal.es

Correspondencia: Dra. L. Vázquez. Servicio de Hematología. Hospital Universitario de Salamanca. Paseo de San Vicente, 58-182. 37007 Salamanca. España.
, José Elías Garcíab
a Servicio de Hematología. Hospital Clínico Universitario. Salamanca. España
b Servicio de Microbiología. Hospital Clínico Universitario. Salamanca. España
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La infección en el huésped deprimido supone una situación clínica de gravedad por su alta morbimortalidad, y es una de las complicaciones más frecuentes del paciente con cáncer. En los pacientes tratados con quimioterapia, el riesgo de infección depende fundamentalmente de la duración y la intensidad de la neutropenia. Es fundamental evaluar cuáles son los patógenos involucrados con mayor probabilidad para iniciar el tratamiento a priori más adecuado, así como la situación clínica general del paciente, que nos obligará a realizar un tratamiento más o menos agresivo desde el inicio, teniendo en cuenta que es posible el manejo domiciliario en el grupo de pacientes considerado de “bajo riesgo” de presentar complicaciones. Podremos conocer estas cuestiones evaluando los antecedentes y la historia clínica del paciente, mediante la exploración física y a partir de los datos del laboratorio y las exploraciones radiológicas. El inicio precoz de la antibioterapia de amplio espectro adaptada al riesgo del paciente es crucial.

Palabras clave:
Fiebre
Neutropenia
Infección
Factores de riesgo

Infection in immunocompromised hosts represents a serious clinical situation due the high morbidity and mortality it produces and is one of the most frequent complications in patients with cancer. In patients treated with chemotherapy the risk of infection mainly depends on the duration and intensity of neutropenia. It is essential to evaluate which pathogens are involved so that the most appropriate treatment can be selected a priori, as well as to determine the patient's general clinical status so that more or less aggressive treatment can be provided from the beginning, bearing in mind that “low risk” patients can be managed in the home. These questions can be determined by evaluating the patient's clinical history, physical examination, laboratory investigations, and radiological tests. Prompt initiation of broad-spectrum antibiotic therapy adapted to the the patient's risk is crucial.

Key words:
Fever
Neutropenia
Infection
Risk factors
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Copyright © 2005. Elsevier España S.L.. Todos los derechos reservados
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