BMJ Best Practice
最后审核时间： 六月 2019
最近更新时间： 三月 2019

小结

定义

病史和查体

关键诊断因素

  • 近期化疗
  • 发热
  • 心动过速
  • 低血压
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其他诊断因素

  • 年龄＞65 岁
  • 既往化疗后中性粒细胞减少发作史
  • 东部肿瘤协作组体力状态 (ECOG PS) ≥1
  • 血液系统恶性肿瘤
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危险因素

  • 年龄＞65 岁
  • 白蛋白＜35 g/L (3.5 g/dL)
  • 已有的器官功能异常（心脏、肾脏、肝脏疾病）
  • 治疗前血红蛋白＜120 g/L (12 g/dL)
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诊断性检查

首要检查

  • 全血细胞计数和分类计数
  • 尿素和肌酐
  • 肝功能检查 (LFT)
  • 细菌血培养：外周和中心静脉导管
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需要考虑的检查

  • 粪便培养
  • 尿液培养
  • 腰椎穿刺术：
  • 真菌培养和血清学检测（β-葡聚糖和半乳甘露聚糖）
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治疗流程

推断

并发症或死亡的中-高风险：初始表现

合并症或死亡低风险：初始表现

急性

抗生素无效：治疗＞3-5天后仍发热

贡献者

作者 查看所有

Instructor in Medicine

Dana Farber Cancer Institute

Boston

MA

利益冲突披露
CJ declares that she has no competing interests.

Dr Caron Jacobson would like to gratefully acknowledge Dr Joseph Antin, a previous contributor to this monograph. JA declares that he has no competing interests.

同行评议专家 查看所有

Price Eminent Scholar and Professor of Medicine

Director

Bone Marrow Transplant Program

Division of Hematology/Oncology

University of Florida College of Medicine

Gainesville

FL

利益冲突披露
JW has been reimbursed by Pfizer, Merck, Astellas, and Enzon for speaking fees, fees for educational programs, and consulting.

Director

Alfa Institute of Biomedical Sciences

Marousi

Athens

Greece

利益冲突披露
MF declares that he has no competing interests.

Senior Lecturer in Haematology

Honorary Consultant in Medical Oncology

St George's University of London

London

UK

利益冲突披露
RP has received speaker fees and been reimbursed by Roche, Amgen, Chigai, and Bayer for attending several conferences. RP is a co-author of the EORTC guidelines referenced in this monograph.

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