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Febrile neutropenia and refeeding syndrome
  1. H K Jahn1,
  2. S Barraclough2,
  3. S Currell2,
  4. M P Tighe2
  1. 1Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
  2. 2Paediatric Department, Poole Hospital NHS Trust, Poole, UK
  1. Correspondence to H K Jahn, Emergency Department, Royal Belfast Hospital for Sick Children, 80 Falls Road, Belfast, BT12 6BE, UK; haiko.jahn{at}


We describe the management of a 4-year-old child with acute lymphoblastic leukaemia (ALL) who presented with febrile neutropenia, Cryptosporidium and subsequently developed refeeding syndrome. Febrile neutropenia is common and can be life-threatening and we highlight the identification of well low-risk neutropenic children with resolved febrile illnesses suitable for early discharge. We also discuss the potential management strategies for Cryptosporidium. Refeeding syndrome is not common, but should be considered as a cause of acute inpatient deterioration and is a significant risk, with potential morbidity, in children who have undergone a period of catabolism. This article reviews the current literature and provides useful guidance on these issues.

  • Oncology
  • General Paediatrics
  • Gastroenterology
  • Infectious Diseases
  • Nutrition

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  • Contributors HKJ: case history and refeeding syndrome, Cryptosporidium. SB and SC: refeeding syndrome nutritional management. MPT: case history and refeeding syndrome, febrile neutropenia.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.