The clinical records were collected from medical records by one of the authors. Patients click here were treated in the children’s hospital Grendacc (HG) and at Hospital Universitário da Faculdade de Medicina de Jundiaí (HUJ) in the city of Jundiaí, São Paulo, Brazil, both funded by the Brazilian Unified Health System (Sistema Único de Saúde – SUS), from January of 2011 to December of 2012. The HUJ is maternal and child hospital, a regional referral center for eight cities, and offers secondary care to a population of approximately 900,000 inhabitants of Jundiaí and surrounding area. The HG is a day-hospital and

referral outpatient clinic that offers assistance for cancer treatment in childhood. The study was approved by the Research Ethics Committee of the Faculdade de Medicina de Jundiaí (N. 366/2009). Study subjects: cancer patients younger

than 21 years with acute respiratory infections (ARIs). A new episode of ARI was considered when there was an interval > 15 days during the study period. ARI: a history of respiratory prodrome, with at least one or more of the following signs or symptoms: fever, coryza, cough, sore throat, and/or gastrointestinal symptoms. Fever: at least one episode Icotinib in vivo of fever, measured or reported, with axillary temperature > 38 °C (based on one measurement) or 37.8 °C (based on two measurements with a 1-hour interval). Hypothermia: temperature < 37.5 °C. Clinical aspects: good overall status, sick, and toxemic.12 Good overall status was defined when the child, at the initial appointment, showed no change in overall appearance and was active, without distress or pain. The patient Amisulpride was considered sick when he/she was irritable, anxious, or had a fatigued or suffering appearance. Toxemic: patient had difficulty breathing, toxemia, lethargy, or alteration of consciousness.

Anemia: (Hb < 10 mg/dL) Neutropenia (absolute neutrophil count [ANC] <500 cells/mm3.13 Thrombocytopenia: total platelet count < 150.000/uL.13 Suspicion of invasive bacterial infection: in the absence of a negative culture, the following clinical criteria were observed: clinical or laboratory findings of sepsis, or hemodynamically unstable child with poor general status. Proven invasive bacterial infection: occurrence of bacteremia (one or more positive blood cultures for bacterial pathogen). Sepsis by coagulase-negative Staphylococcus requires two or more positive blood cultures collected on the same day; probable sepsis is indicated if there are two blood cultures for coagulase-negative Staphylococcus within a four-day interval, or three blood cultures within seven days, or four blood cultures within ten days.