Evaluation of the Most Common Viral Causes of Fever and Neutropenia in Children Hospitalized in Abuzar Children’s Medical Center in Ahvaz, Iran

Abstract

Background: Viral infections are the most common cause of fever and neutropenia in children without underlying disease, and data are still limited in this regard. Objective: This study aimed to identify the most common viral causes of fever and neutropenia in pediatrics. Methods: This descriptive-analytical study was conducted on pediatric patients younger than 18 years old referred to the pediatric emergency ward with fever as the chief complaint and no underlying diseases; patients with neutropenia and no evidence of bacterial infections in terms of different cultures were included in the study. After obtaining parental consent, nasopharyngeal swab specimens were taken from patients during the coronavirus disease 2019 (COVID-19) pandemic, and blood samples were analyzed to detect viruses in each patient. Results: Fifty patients (54.3%) had mild neutropenia (absolute neutrophil count (ANC): 1000 - 1500/μL), 40 patients (43.5%) had moderate neutropenia (ANC: 1000 - 500/μL), and 2 cases (2.2%) had severe neutropenia (ANC < 500/μL). Among all the cases, 19 cases were positive in terms of virus examination, including adenovirus (6.5%), enterovirus (5.4%), cytomegalovirus (CMV) (3.3%), Epstein-Barr virus (EBV) (3.3%), and Herpes virus 6 (2.2%). A significant correlation was found between enterovirus and neutropenia (P = 0.005). Conclusions: The most common viruses found in neutropenic children hospitalized due to fever without any underlying disease were adenovirus and enterovirus, respectively. Considering the good general condition and relatively quick recovery, consideration of viral causes is recommended in this category of patients, and it is better to avoid prescribing broad-spectrum antibiotics, and careful follow-up should be carried out.