Is routine chest radiography necessary for the initial evaluation of fever in neutropenic children with cancer?
Renoult E; Buteau C; Turgeon N; Moghrabi A; Duval M; Tapiero B Infectious Diseases Division, Hôpital Sainte-Justine, University of Montreal (Quebec), Canada. erenoult@msn.com BACKGROUND: The yield of routine chest radiography (CXR) as part of the initial management of febrile neutropenic pediatric oncology patients is questionable. PROCEDURE: We retrospectively analyzed the clinical records of neutropenic (absolute neutrophil count or = 38 degrees C to our institution, between January 2001 and October 2002. Following admission, patients received tobramycin plus (piperacillin or ticarcillin-clavulanic acid). Admission routine CXRs were reviewed. Clinical and radiological features were compared with the discharge diagnosis. Age, underlying disease, and the presence of pulmonary symptoms or signs were studied as possible predictors of CXR findings related to pneumonia. RESULTS: In total, 88 patients experienced 170 episodes of fever. A routine admission CXR was obtained for 157 of the epi
