M the infectious diseases working party of the German Society of Hematology and Oncology [10] for the management of sepsis in neutropenic patient recommend the use of norepinephrine as the drug of choice if a sufficient mean arterial pressure (> 65 mmHg) cannot be achieved by fluid resuscitation, associated with dobutamine in case of sepsis-related myocardial depression . Moreover, D. Schnell and
Rianal cellulitisPerianal cellulitis should be promptly recognized in neutropenic patients, as they are associated with significant morbidity and mortality [52]. Necrotizing cellulitis and cellulitis-induced septic shock require surgery. However, surgery is sometimes a complex decision and some authors suggest that, in the absence of septic shock, the management depends on the presence of fluctuat
The small or large intestine is indicative of pneumatosis intestinalis. This situation refers to a necrotizing enterocolitis and can be considered as an indication for urgent surgery. Conservative management is recommended initially when these criteria are absent [50]. Badgwell et al. suggested better outcomes if it was possible to delay surgery until recovery from neutropenia [51]. General suppor
M the infectious diseases working party of the German Society of Hematology and Oncology [10] for the management of sepsis in neutropenic patient recommend the use of norepinephrine as the drug of choice if a sufficient mean arterial pressure (> 65 mmHg) cannot be achieved by fluid resuscitation, associated with dobutamine in case of sepsis-related myocardial depression . Moreover, D. Schnell and
Ithout malignancy [53].Non anti-infectious agentsG-CSF and GM-CSFHaemopoietic growth factors, such as granulocyte colonystimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been assessed in several clinical trials [54,55]. The known effect of G-CSF and GM-CSF in increasing the number of circulating neutrophil granulocytes was the rationale for clinical stud
Ithout malignancy [53].Non anti-infectious agentsG-CSF and GM-CSFHaemopoietic growth factors, such as granulocyte colonystimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been assessed in several clinical trials [54,55]. The known effect of G-CSF and GM-CSF in increasing the number of circulating neutrophil granulocytes was the rationale for clinical stud
Ithout malignancy [53].Non anti-infectious agentsG-CSF and GM-CSFHaemopoietic growth factors, such as granulocyte colonystimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been assessed in several clinical trials [54,55]. The known effect of G-CSF and GM-CSF in increasing the number of circulating neutrophil granulocytes was the rationale for clinical stud
For removal in patients with septic shock, without an obvious other source of infection as the absence of local signs and symptoms are notoriously insensitive in the neutropenic host. In a cohort study of neutropenic cancer patients admitted to the ICU for severe sepsis or septic shock, Legrand et al. found that routinely removing indwelling catheters early on in patients with no other detectable