{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:48:44Z","timestamp":1792100924432,"version":"4.4.0"},"reference-count":25,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T00:00:00Z","timestamp":1506384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Despite major advances in its prevention and treatment, febrile neutropenia remains a most concerning complication of cancer chemotherapy. Outside the oncology setting, however, only few data are currently available on febrile neutropenia related to non-chemotherapy drugs. We report here data on 76 patients with febrile neutropenia related to non-chemotherapy drugs, followed up in a referral center within a university hospital. Patients and methods: Data from 76 patients with idiosyncratic drug-induced febrile neutropenia were retrospectively reviewed. All cases were extracted from a cohort study on agranulocytosis conducted at the Strasbourg University Hospital (Strasbourg, France). Results: Mean patient age was 52.2 years old (range: 18\u201393) and gender ratio (F\/M) 1.6, with several comorbidities present in 86.8% of patients. The most common causative drugs were: antibiotics (37.4%), antithyroid drugs (17.2%), neuroleptic and anti-epileptic agents (13.1%), non-steroidal anti-inflammatory agents and analgesics (8%), and platelet aggregation inhibitors (8%). Main clinical presentations upon hospitalization included isolated fever (30%), sore throat, acute tonsillitis and sinusitis (18.4%), documented pneumonia (18.4%), septicemia (14.5%), and septic shock (6.6%). Mean neutrophil count at nadir was 0.13 \u00d7 10(9)\/L (range: 0\u20130.48). While in hospital, 22 patients (28.9%) worsened clinically and required intensive care unit placement. All patients were promptly treated with broad-spectrum antibiotics, and 45 (59.2%) with hematopoietic growth factors. Mean duration of hematological recovery (neutrophil count \u22651.5 \u00d7 10(9)\/L) was 7.5 days (range: 2\u201321), which was reduced to 0.7 days (range: 2\u201316) (p = 0.089) with hematopoietic growth factors. Outcome was favorable in 89.5% of patients, whereas eight died. Conclusions: Like in oncology and myelosuppressive chemotherapy settings, idiosyncratic febrile neutropenia is typically serious, about 40% of patients exhibiting severe pneumonia, septicemia, and septic shock, with a mortality rate of 10%. Like in febrile, chemotherapy-related neutropenia, modern and timely management (immediate broad spectrum antibiotherapy, hematopoietic growth factors) may reduce infection-related mortality. All practitioners should be aware of this potential side-effect that may even occur in the event of \u201cdaily medication\u201d exposure.<\/jats:p>","DOI":"10.3390\/jcm6100092","type":"journal-article","created":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T16:14:45Z","timestamp":1506442485000},"page":"92","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["History and Outcome of Febrile Neutropenia Outside the Oncology Setting: A Retrospective Study of 76 Cases Related to Non-Chemotherapy Drugs"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7914-7616","authenticated-orcid":false,"given":"Emmanuel","family":"Andr\u00e8s","sequence":"first","affiliation":[{"name":"Departments of Internal, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Mourot-Cottet","sequence":"additional","affiliation":[{"name":"Departments of Internal, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Maloisel","sequence":"additional","affiliation":[{"name":"Departments of Onco-hematology, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Keller","sequence":"additional","affiliation":[{"name":"Departments of Internal, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Vogel","sequence":"additional","affiliation":[{"name":"Departments of Geriatrics, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"S\u00e9verac","sequence":"additional","affiliation":[{"name":"Departments of Statistics, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Tebacher","sequence":"additional","affiliation":[{"name":"Regional Pharmacovigilance Centre of Alsace, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques-Eric","family":"Gottenberg","sequence":"additional","affiliation":[{"name":"Departments of Rheumatology, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Weber","sequence":"additional","affiliation":[{"name":"Departments of Internal, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Kaltenbach","sequence":"additional","affiliation":[{"name":"Departments of Geriatrics, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Goichot","sequence":"additional","affiliation":[{"name":"Departments of Internal, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Sibilia","sequence":"additional","affiliation":[{"name":"Departments of Rheumatology, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Korganow","sequence":"additional","affiliation":[{"name":"Departments of Internal, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raoul","family":"Herbrecht","sequence":"additional","affiliation":[{"name":"Departments of Onco-hematology, Strasbourg University Hospitals, Strasbourg 67000, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,9,26]]},"reference":[{"key":"ref_1","first-page":"825","article-title":"Management of neutropenia in cancer patients","volume":"10","author":"Lustberg","year":"2012","journal-title":"Clin. 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