Booklet for Hemato-Oncologists
Case 4 (A, B) - Febrile neutropenia during induction therapy of AML
Child, 6 year old, male, receiving induction phase for AML (day +5). He was in aplasia (ANC < 500/mm³), and at the same time developed fever (38.8°C). A central venous line has been inserted with the start of chemotherapy. Supportive care consisted of TMP/SMX and intravenous fluconazole.
A - When should you start an antibiotic treatment?
2. If fever persists for more than 2 hours
3. If CrP is significantly elevated
4. When blood cultures become positive
5. Not at all
B - Which antimicrobial agent(s) do you consider most appropriate for initial treatment of fever of undetermined origin (FUO) in aplasia (ANC < 500/µl)?
1. Vancomycin + Penicillin
2. Cephalosporine + Amphotericin B
3. Monotherapy with ceftazidime or imipenem
4. Vancomycin + Aminoglycoside
5. Oral antibiotics
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