Paeds Cases · infectious-diseases
Infections in immunocompromised children — OSCE
OSCE communication and clinical reasoning station for a newly diagnosed oncology child and parental counselling on the fever action plan.
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Target exams
MRCPCH ClinicalRACP DCE
Prompt
You have 8 minutes with a parent whose 6-year-old has just started maintenance chemotherapy for acute lymphoblastic leukaemia and has a central venous catheter. Explain what neutropenia means, when the parent must bring the child in, and agree a written fever action plan.
Station brief (candidate)
- Explain what neutropenia means in plain language a parent can understand and act on.
- State clearly when the parent must bring the child to hospital and why the threshold is any fever, not a high fever.
- Outline what will happen when they arrive: cultures, empiric antibiotic within the hour, admission.
- Agree a written fever action plan and confirm understanding with teach-back.
- Avoid reassuring the parent that a low-grade fever can wait, or that the child's appearance is a reliable guide. [1] [2]
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References3Show ledgerHide ledger
- [1]Lehrnbecher T Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update. Journal of clinical oncology, 2023.PMID 36689694
- [2]De S Lack of Accuracy of Body Temperature for Detecting Serious Bacterial Infection in Febrile Episodes. The Pediatric infectious disease journal, 2015.PMID 26065864
- [3]Maertens J ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients. The Journal of antimicrobial chemotherapy, 2016.PMID 27550992