NEUTROPENIA IN THE PEDIATRIC POPULATION AND ITS ASSOCIATION WITH INFECTION

Abstract

Neutropenia, defined as an absolute neutrophil count <1000, occurs frequently in the general pediatric population. Its incidence and association with infection, both self-limited and more serious, have not been well described.

A retrospective review of 1198 inpatients and 215 outpatients was performed to determine the incidence. Three percent of inpatients were found to have neutropenia. However, 80% of the children presenting with neutropenia were without signs or symptoms of infection. Three children had associated viral symptoms, 1 had a documented bacterial meningitis and 2 had a combination of viral and bacterial infection. The largest single diagnosis associated with neutropenia was serous otitis media (SOM), accounting for 35% of neutropenia inpatients. While making up only 35% of total admissions, 7.5% of all patients with the diagnosis of SOM had neutropenia.

Of 215 outpatients reviewed, 7% were neutropenic. As with the inpatient group, a majority of children with neutropenia were without signs and symptoms of infection.

Neutropenia appears to be a common incidental finding in otherwise healthy children. In our study, it was most commonly seen with serous otitis media. We conclude that neutropenia represented by the patients reviewed here is most likely shortlived, transient in nature, and needs no special evaluation or altered treatment plan, unless persistent or recurrent.

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