Fever - non-infectious
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Shared care information
Patients thought to have a non-infectious fever should be discussed with the oncologist on call.
Non infectious fevers
All fevers in oncology children should be initially treated as presumed bacterial sepsis. Ongoing fevers generally lead to the institution of further antimicrobials including antifungal or antiviral agents. Occasionally, children may have fevers that are not caused by infectious agents. Causes include:
- Drug fevers
- Cytarbine (Ara-C) - very common at high doses
- Fevers secondary to underlying malignancy
- Post surgical fever
- Pulmonary embolism
- Haematomas in abdominal viscera
- Febrile transfusion reactions
- Tumour lysis syndrome.
The decision to stop antibiotics in a febrile oncology child is difficult and should be made by the treating oncologist. In most situations antibiotic therapy should be instituted at the onset of fever and stopped again if non infectious fever is thought more likely later on.
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- Date last published: 03 March 2014
- Document type: Clinical Guideline
- Services responsible: National Child Cancer Network
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