Presse Med
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A NEW Keeping neutropenic patients with fever in their homes helps to preserve their quality of life and reduces the costs. However, it is important to specify the conditions and the means necessary for the organisation so that home treatment can be applied safely because of the high risk of morbidity due to infection. THE FUNDAMENTAL CONDITIONS FOR ITS MANAGEMENT: The patients who could potentially benefit from an outpatient treatment strategy when presenting with neutropenia and fever must not have a tumour progressing and must not exhibit signs of co-morbidity and be affected by neutropenia and fever at home. ⋯ The development of nursing networks ensure the continuity between the hospital and the town and the good coordination of the health workers caring for the patient. The steps to be taken during an episode of fever are debated: complete discharge from hospital for some, initial outpatient controls in the hospital for several hours for others and the initial hospitalisation for 24 to 72 hours for some others. Whatever the case, haemocultures must be performed before the initiation of any antibiotherapy.
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INFECTIOUS AGENT: The severe acute respiratory syndrome (SARS) is a febrile pneumonia initially observed in China at the end of 2002. The infectious agent has rapidly been identified as a new coronavirus, baptised SARS-associated coronavirus (CoV-SARS). Transmission is inter-human, via respiratory particles mainly. ⋯ During the first half of 2003, the spreading of the virus has been very fast, with a pandemic mode of evolution. More than 8,000 people were infected and 774 died. The reservoir of the virus, which may be animal, is still unknown. The epidemic seems to be controlled, but sporadic or epidemic re-emergences may occur and have been observed in China during January 2004.