Accentuate the Gram positive: an unusual infection in an oncology patient

A 3-year-old boy was diagnosed with Wilms tumour. A central line was inserted and treatment was commenced as per the Children’s Cancer and Leukaemia Group preoperative guidelines for Wilms tumour, following which a nephrectomy was performed. During week 7 of postoperative chemotherapy with vincristine and actinomycin, he developed a fever of 38.5°C at home and was immediately brought to hospital. Question 1 Which of the following scenarios would cause you to delay administration of broad spectrum antibiotics? A nurse remeasures his temperature and it is 37.5°C On clinical assessment he is well and has only minor coryzal symptoms Neutrophil count 24 hours previously was 1.5x109/L Blood samples could not be obtained because the central line is difficult to access None of the above. He was commenced on intravenous piperacillin with tazobactam. Initial full blood count showed neutrophils to be 1.4x109/L. Fever persisted...
Source: Archives of Disease in Childhood - Education and Practice - Category: Pediatrics Authors: Tags: Epilogue Source Type: research