Risk of infectious complications in well-appearing children with transient neutropenia
A. J. Alario and J. S. O'Shea
Department of Pediatrics, Rhode Island Hospital, Providence 02903.
To determine whether well-appearing children found incidentally to be
neutropenic are at risk for an infectious complication, 44 consecutive
months of hematology laboratory records were reviewed. One hundred nineteen
patients had medical record documentation regarding clinical course, serial
white blood cell counts, and the absence of serious infections, chronic
illnesses, or a family history known to be associated with neutropenia. The
median duration of documented neutropenia was 13 days (range, 1 to 491
days). Infectious complications occurred in 4 of the 36 patients who had
neutropenia for more than 30 days (2 with stomatitis, 1 with cellulitis,
and 1 with pneumonia) but in none with shorter durations of neutropenia.
There were no significant associations between the development of an
infectious complication and either the initial absolute neutrophil count or
the lowest documented absolute neutrophil count, nor was there a
correlation between the initial absolute neutrophil count and the duration
of neutropenia. These data indicate that infectious complications occur in
otherwise well children with unexplained neutropenia that persists, but
these infections are infrequent and usually are superficial.
