Term
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Definition
| Hematopoietic Cell> Myeloid Stem Cell>Myeloblast> Neutrophil |
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Term
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Definition
Single temp >101F
Temp >/= 100.4F for more than one hour |
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Term
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Definition
ANC </= 500 cells/mm^3
ANC </= 1000mm^3 with predicted decrease to <500 |
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Term
| Absolute Neutrophil Count |
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Definition
| ANC = (%Segs + %Bands) x WBC |
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Term
| Neutropenia usually associated with |
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Definition
~1/2 have documented infection
~ 1/3 microbiologic diagnosis |
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Term
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Definition
ANC
Illness underlying
Tx regimen for cancer
Genes |
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Term
| Predominant cause of bacteremia |
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Definition
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Term
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Definition
Mostly Bacteremia and Respiratory tract
Then UTI,SKin/Soft tissue,GI(C.Dif) |
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Term
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Definition
Fever may be only Sx
(Treat ASAP) |
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Term
| Low risk Pts treated How? |
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Definition
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Term
| High risk Pts treated How? |
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Definition
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Term
| Talcott Subgroup analysis |
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Definition
Group 1(inpt Highest risk/mortality)
Group 4 (uncomplicated fever and neutropenia) |
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Term
|
Definition
>/= 21 = low risk
1-26 points
(lower score means higher risk) |
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Term
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Definition
-Outpt tx
-MASCC >/=21
-Talcott group IV
solid tumor w/ mild-mod intensity chemoTx
-Neutropenia Duration <7 days |
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Term
| Initial Empiric ABX Tx LOW RISK |
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Definition
CIPRO 500-750mg po q 12 H
+ Amox-Clav 875 mg PO q12h |
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Term
| PCN allergic pt empiric TX |
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Definition
Levo + Azithro
Cipro + Azithro
Moxi + Azithro
Cipro + Clindamycin |
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Term
| Initial Empiric ABX Tx HIGH RISK |
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Definition
InPt Tx
Need Pseudomonas Coverage
-Monotx,Dual Tx w/o glycopeptide, Glycopeptide w/ 1 or 2 addition antibiotics |
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Term
|
Definition
-Pip~tazo
-Cefepime or Ceftazidime
-Dori,Imi, or Meropenem |
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Term
|
Definition
MRSA and/or resistant Strep Viridans
Hemodynamic instability or severe sepsis
Pneumonia documented
Hx of MRSA Gram + blood culture before susceptibiity
Severe Mucositis, if Fluoraquinolone Prophylaxis was used |
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Term
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Definition
| -No growth from blood cultures at 48 hours |
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Term
Modifications to consider
VRE, MRSA, ESBLs, KPCs |
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Definition
VRE: Linezolid, Dapto
MRSA: Vanco, Linezolid, Dapto
ESBLs: Carbapenem
KPCs: Polymyxin-Colistin, or tigecycline |
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Term
|
Definition
Candida
Aspergillus
Zygomycetes |
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Term
|
Definition
FLuconazole
Posaconazole
Voriconazole
Echinocandins
Ampho B products |
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Term
| When consider mold active agents? |
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Definition
-Induction ChemoTx for AML/MDS
-Stem cell transplant
(Prior invasive Aspergillosis,Anticpated neutropenia >2weeks,Prolonged neutropenia immediately prior to HSCT) |
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Term
| Antiviral Prophylaxis Drugs |
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Definition
Acyclovir ***
Valacyclovir,Famciclovir,Ganciclovir,Valganciclovir |
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Term
|
Definition
| Acyclovir recommended (given during periods of Neutropenia & mucosal breakdown) |
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Term
| Cytomegalovirus Prophylaxis |
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Definition
-Prophylaxis versus preemptive Ganciclovir
-Post allogeneic transplant while on immunosuppressants |
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Term
| VZV infection Prophylaxis |
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Definition
-For one year post HSCT
-During Bortezomib Therapy
(acyc,Valacyc,famcyc,gancyc) |
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Term
| Ganciclovir?Valganciclovir SFX |
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Definition
|
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Term
| Acyclovir?Valacyclovir SFX |
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Definition
| Careful in Renal Impairment |
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