{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:07:04Z","timestamp":1784700424653,"version":"3.55.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Febrile neutropenia (FN) is a serious and potentially life-threatening complication in children with acute myeloid leukemia (AML), particularly during induction chemotherapy. However, data from low- and middle-income countries remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study including children and adolescents with newly diagnosed AML who experienced at least one FN episode during induction therapy at Aziza Othmana Hospital, Tunis, Tunisia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 63 patients with AML, 55 (87.3%) experienced 82 FN episodes. No patient received antibacterial or antifungal prophylaxis. Clinically documented infections (CDI) accounted for 53.6% of episodes, fever of unknown origin for 25.7%, and microbiologically documented infections (MDI) for 20.7%. The gastrointestinal tract was the most frequent site of infection (50%), followed by the respiratory tract (31.8%). Blood cultures yielded predominantly Gram-negative bacilli and Gram-positive cocci in similar proportions. Multidrug-resistant Gram-negative bacteria were identified in five episodes. Clinical outcomes were favorable in 77 episodes (94%), with a median time to defervescence of four days. Five patients died, resulting in a FN-related mortality rate of 9%. Intensive care unit (ICU) admission and presence of sepsis\/septic shock were associated with mortality in univariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>FN remains a major cause of morbidity and mortality during AML induction therapy. Early recognition, prompt antimicrobial treatment, and improved access to microbiological diagnostics may improve outcomes in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1883346","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:55:44Z","timestamp":1784699744000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Febrile neutropenia in children and adolescents with acute myeloid leukemia during induction therapy"],"prefix":"10.3389","volume":"14","author":[{"given":"Manel","family":"Rebah","sequence":"first","affiliation":[{"name":"Clinical Hematology Department, Oncohematology UR14ES11, Aziza Othmana Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emna","family":"Azza","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Oncohematology UR14ES11, Aziza Othmana Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emna","family":"Ben Jemia","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Charles Nicolle Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosr","family":"Ben Abdennebi","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Oncohematology UR14ES11, Aziza Othmana Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eya","family":"Ben Othmen","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Oncohematology UR14ES11, Aziza Othmana Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roua","family":"Hsasna","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Oncohematology UR14ES11, Aziza Othmana Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maroua","family":"Bahri","sequence":"additional","affiliation":[{"name":"Clinical Hematology Department, Oncohematology UR14ES11, Aziza Othmana Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamia","family":"Aissaoui","sequence":"additional","affiliation":[{"name":"Clinical Hematology 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