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Infectious Etiologies of Transient Neutropenia in Previously Healthy Children
The Pediatric Infectious Disease Journal, 05/31/2012
Husain EH et al. – Neutropenia in previously healthy children in Kuwait is caused by demonstrable infections in 55% of cases. Majority of children will recover their absolute neutrophil count (ANC) completely within 1 month without significant infectious complications.
Methods- A 2-year prospective study was conducted at a tertiary hospital in Kuwait.
- All previously healthy children (aged 1 month to 12 years) hospitalized with isolated neutropenia defined as absolute neutrophil count (ANC) 1.5 × 109/L were enrolled in the study.
- Investigations to identify the infectious causes included blood and urine culture for bacteria whereas for viruses, serology for Epstein-Barr virus, cytomegalovirus, adenovirus, parvovirus and polymerase chain reaction for human herpes virus 6 and enterovirus were performed.
- Fifty-five children were enrolled during the study.
- Children less than 2 years of age constituted 73% of the sample.
- There were 2 peaks of presentation: March–May (33%) and September–November (38%).
- Associated features were congested throat (56%), runny nose (53%) and cervical lymphadenopathy (20%). The median ANC on admission was 0.6 × 109/L.
- Associated infections were documented in 55% of enrolled children and were as follows: human herpesvirus 6, 30%; enterovirus, 23%; influenza A H1N1, 13%; parvovirus, 10%; Epstein-Barr virus, 10%; urinary tract infection, (Eshcherichia coli) 7%; and adenovirus, 7%.