Fever and neutropenia after chemotherapy [Fieber und Neutropenie nach Chemotherapie]

Background: Fever and neutropenia after chemotherapy (FN) is one of the most common therapy-associated complications in children with cancer. This potentially life-threatening event is partially due to bacterial infections. A standardized and quick work-up is essential. Diagnosis: The identification of a high-risk patient with regard to anamnestic and clinical parameters as well as the detection of the underlying pathogen is crucial. A defined site of infection is rarely revealed. Common inflammatory parameters as C-reactive protein and procalcitonin are not considered significantly helpful in the decision-making process of antibiotic use. Treatment: Antibiotic therapy has to be initiated immediately. In concern of resistant bacterial and fungal and viral pathogens, respectively, therapy modification should be based on clinical and microbiologic factors. Conclusion: In this article, diagnostic and therapeutic procedures are reviewed. © 2013 Springer-Verlag Berlin Heidelberg.