Febrile neutropaenia and role of bacterial surveillance cultures.

Modern day cancer management is complicated by aggressive chemotherapy and suppressed immunity. Chemotherapy leads to neutropaenia and breaches in the mucosal barriers. Contamination of the external and internal milieu of such neutropaenic patients leads to febrile neutropaenic situations, which are often complicated by stomatitis. All of them ultimately lead to development of life threatening complications. Use of catheters and other intravascular tubings along with empirical antibiotic prophylaxis and antibiotic therapy also lead to emergence of a change in the microbial profile. Both the domestic and nosocomial infections affect the microbial flora hence the surveillance cultures are often advocated, which are at present possibly useful in scientific studies for determining hospital policy for empirical antibiotic therapy. Patients with non-regenerating marrow are at a higher risk and they require colony stimulating factors. Nonspecific hygienic precautions and antibiotic prophylaxis help avert many a crisis in these patients.