Infection in Childhood Cancer

 

Symptom Management, Palliative Care, or Supportive Care to relieve side-effects is an important part of cancer care and treatment and should always form part of the overall treatment plan.

An infection occurs when the immune system is not able to destroy harmful bacteria, viruses, or fungi or yeast quickly. Individuals with cancer are far more likely to develop infections easily because both the cancer itself as well as the cancer treatments weakens their immune system.

The immune system fights bacteria, viruses, and fungi that try to invade the body and includes the skin, the spleen, lymph nodes, the bone marrow and white blood cells called leukocytes and neutrophils, which help fight infections and destroy harmful substances.

A low level of neutrophils, called neutropenia, often increases the risk of developing dangerous infections. Leukopenia is when the body does not have enough white blood cells to fight infections.

 

Signs and Symptoms

Relieving side effects is an important part of total cancer care and treatment, which is why you should discuss any symptoms your child is experiencing, new symptoms and changes in symptoms with their Oncology Team so that they can work out a regimen of palliative or supportive care for them.

Individuals with cancer, neutropenia, or a low white blood cell count are more likely to develop a serious infection.

Infections can start almost anywhere; common areas for an infection to start include the mouth, skin, lungs, urinary tract, rectum, and the genitals.

Speak to your child’s doctor right away if they experience any of the following signs of infection:

  • A cough or shortness of breath
  • A fever, which is a temperature of 38°C or higher
  • Abdominal pain
  • Any redness, swelling, or pain, particularly around a cut, wound, or where a catheter was placed
  • Chills or sweating
  • Diarrhoea or sores around their bottom
  • Pain near their bottom
  • Pain or burning when urinating, or urinating often
  • Sore throat, sores in the mouth, or a toothache
  • Unusual vaginal discharge or itching

 

Possible Causes

There are various factors related to cancer and cancer treatment that can affect your child’s white blood cells and lower their immune system, which makes it easy for an infection to take hold.

It is for this reason that one needs to be very careful around Children with Cancer, and why their visitors should be kept to the minimum and screened, because the slightest sign of a cold or infection of any type in a visitor could transfer to your child and make them very ill.

Possible causes include:

  • Lack of sleep, stress, poor diet, and other side effects
  • Chemotherapy
  • Radiation therapy given to larger areas of the body or to the pelvis, legs, chest, or abdomen
  • Cancers that affect the bone marrow directly, such as leukaemia and lymphoma
  • Cancers that spread to the bone

 

Management/Treatment

Your child’s doctor may prescribe preventive antibiotics or antifungal medications if they have a high risk of developing an infection. Neutropenia, some types of chemotherapy, and radiation therapy may place your child at a higher risk for infection.

Your child’s doctor may also prescribe antibiotics or antifungal medications if they develop an infection. If they develop neutropenia with a fever, they may need to stay in the hospital until the infection is gone.

If your child has had or has a higher risk of developing neutropenia with a fever, their doctor may prescribe medications called white blood cell growth factors which help the body make more white blood cells to reduce the risk of an infection.

 

Tips for Preventing Infections

There are steps you can take to help prevent your child from getting infections, even if they do have an impaired immune system due to their cancer or to the treatment that they are receiving for their cancer.

Here are a few easy tips to remember:

  • Make sure your child gets plenty of rest and eats a well-balanced diet
  • Make sure your child does not come into contact with people who are sick
  • Do not let your child share food, drink cups, utensils, or other personal items, such as toothbrushes and makeup with anyone else
  • Make sure your child washes their hands thoroughly and frequently or uses antibacterial hand sanitisers, especially after using the bathroom and before eating
  • Make sure your child showers or bathes daily and applies lotion to prevent their skin from becoming dry and cracked
  • Make sure your child is extra careful when using sharp objects such as scissors or knives, to avoid cuts.
  • Do not give your child eat raw foods to eat, including meats, shellfish, and eggs, and wash raw fruits and vegetables. Make sure that they do not do so themselves either when they are not with you.
  • Do not allow your child to change cat litter or handle animal waste
  • Buy your child a soft toothbrush with which to clean their teeth and gums and, if their doctor or dentist recommends one, a mouthwash to prevent infections.

 

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