Proper management of a child with an absolute neutrophil count (ANC) of 100/mm3 would be
Correct Answer: The start of broad-spectrum intravenous antibiotics
Description: A child with an absolute neutrophil count (ANC) of 100/mm3 is severely neutropenic and is at risk of death from overwhelming septicemia. Because most signs of infection (e.g., pneumonitis, pyuria) depend on the presence of neutrophils, serious infection may be present in such a patient without producing characteristic physical, radiologic, or laboratory findings. Thus, broad spectrum antibiotics (to treat a variety of possible infections) must be initiated promptly after cultures are obtained. Deferring treatment until culture results are available may result in overwhelming septicemia and death. Granulocyte transfusions usually are not beneficial in these patients because of the short survival time of the cells in the bloodstream (plasma half-life is approximately 7 hours). Iron and vitamin B12 are treatments for nutritional anemias and are of no therapeutic' value in neutropenia.
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