Infections During Childhood Cancer

Because of lowered white blood cell counts from chemotherapy, infections can be particularly serious. There is the potential for the development of serious and unusual infections, and any sign of infection, such as fever, should be reported to your child's physician as soon as possible.

To determine the cause of the infection, the physician may ask that cultures be taken of any sores as well as of the blood, urine, throat, and stool. If it is a bacterial infection, antibiotics will be given to control it. These may be given either orally or intravenously. Depending on the severity of the infection and your physician's policy, your child may be hospitalized. The cultures taken earlier will usually be repeated to check the course of the infection and the effectiveness of the antibiotic treatment.

Antibiotics will not be used if the infection is caused by a virus, because antibiotics are ineffective in treating viral infections. In these cases, chemotherapy may be stopped for a time and medication given to ease the symptoms while your child's blood counts and general condition are closely monitored.

Some viral infections, such as chickenpox, can be particularly dangerous to a child receiving chemotherapy, because complications from the infection may arise. Notify your child's physician immediately if your child has been exposed, because certain measures can be taken such as decreasing drug doses or using a special gamma globulin. If your child attends school, teachers should know to inform you at once if a schoolmate develops chickenpox.

Most children who have had chickenpox are immune for life and will not contract it, even if exposed while in relapse or on chemotherapy. However, some children on chemotherapy who have already had chickenpox may, when exposed to it again, develop shingles. This is a blistery-like skin rash that resembles chickenpox but, instead of appearing all over the body, is confined to one area. Although complications from shingles are less likely than from chickenpox, notify your physician if you suspect your child has shingles.

Regular or red measles (also known as rubeola or hard 9-day measles) may also be more serious for a child on chemotherapy. If the child is exposed to this type of measles, your physician should be notified. Regular gamma globulin may be given in an attempt to prevent or control the infection.

There is no evidence that infections play any role in activating the cancer or causing a relapse. As stated earlier, your child will tolerate most infections as well as if he or she did not have cancer. Chemotherapy may be stopped during the period of infection, depending on the severity of the infection and the child's white cell count. Your physician will be the best judge of whether this should be done.

Your child may miss some oral medications because of a gastrointestinal infection. Contact the physician or treatment center if this occurs. Brief interruptions of medicine for such reasons do not seem to jeopardize the welfare of the child.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.