Abstract
Introduction: Systemic infection leading to multiorgan failure during neutropenia is one of the
leading causes of treatment-related mortality among children receiving chemotherapy.
Reliable markers are needed to diagnose or rule out infection, to reduce the empirical
use of broad-spectrum antibiotic therapy. Aims and Objectives: The aim is to compare the role of interleukin-6 versus C-reactive protein (CRP) as
markers of sepsis in febrile neutropenia in pediatric patients while on chemotherapy
for malignancy. Materials and Methods: This was a prospective observational study carried out in the Department of Paediatrics
of a tertiary care Hospital in South India. All children with malignancy in the age
group from 1 month to 18 years diagnosed to have febrile neutropenia during any phase
of chemotherapy were included in the study. Multiple episodes of febrile neutropenia
in the same child were analyzed as separate episodes. Results: Thirty-two episodes of febrile neutropenia were analyzed. There were 7 microbiologically
documented infections (MDI), 19 clinically documented infections and 6 episodes of
fever of unknown origin. Out of the 7 MDI, 5 were Gram-negative sepsis and 2 were
Gram-positive sepsis. Gram-negative sepsis had a much higher median IL-6 value (169)
than Gram-positive sepsis (17.5) and sterile blood cultures (52). However, median
value of CRP was only slightly higher in Gram-positive sepsis (85.5) than in Gram-negative
sepsis (60.7) and sterile blood cultures (44.2). Conclusion: In this study, higher IL-6 values predicted Gram-negative sepsis better than CRP.
Keywords
C-reactive protein - febrile neutropenia - interleukin-6
