Download Neutropenic Fever

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John Q. Patient
Dr. Smith
General Medicine
617-555-1212
November 16, 2015
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Neutropenic Fever
(Febrile Neutropenia)
Definition
A neutropenic fever is a temperature over 100.4°F (38°C) in a person with neutropenia. Neutropenia is a
descriptive term referring to having a low number of neutrophils in the blood. A neutrophil is a type of white
blood cell that helps to fight bacterial infections. As a result, when the neutrophil counts are low, the body is
much more susceptible to infections.
Medical care is important at the first sign of fever to best manage the cause of the fever and decrease the risk
of serious complications.
White Blood Cells
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Causes
The fever is usually caused by an infection.
The body needs a specific range of neutrophils help to prevent and fight infections in the body. When the
number of white blood cells in the body drops below normal levels, the body is less able to stop infections
from developing or fight infections that have started. Early treatment of neutropenic fever is important to
help the body fight the infection before complications develop. The reduction of neutrophils has a number of
causes, but is most commonly associated with cancer or cancer treatments.
Risk Factors
Having neutropenia increases the chance of infection. The lower the neutrophil count and the longer it is
present, the higher the risk. Other factors that may increase the chance of neutropenic fever include:
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Increasing age
Uncontrolled cancer
Chronic obstructive pulmonary disease (COPD)
Liver or kidney problems
Symptoms
The hallmark symptom of neutropenic fever is a body temperature over 100.4 degrees Fahrenheit (38 degrees
Celsius). In some cases, it may be the only symptom.
Other symptoms of fever include:
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Chills
Sweating
The infection may cause other symptoms depending on location and severity of infection. For example, a
urinary tract infection may cause a burning sensation during urination, an infection in the lungs may cause a
painful cough.
Diagnosis
You will be asked about your symptoms and medical history. A fever can be diagnosed by taking your
temperature. If you have not been diagnosed with neutropenia, but your doctor suspects it based on your
medical history, a blood test will be done for confirmation. Neutrophils are measured as part of a blood test
called a CBC (complete blood count) that measures both red and white blood cell counts in the blood.
One or more of the following tests will help identify the specific cause of the infection:
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Blood tests and culture
Urine tests and culture
Cultures to test other suspicious tissue
Sputum samples
Stool samples
Lumbar puncture—evaluates the cerebrospinal fluid that protects the brain and spinal cord
Biopsy—tissue samples are examined under a microscope
X-rays of areas suspected as the infection source, such as the lungs or sinuses
Treatment
Treatment is started immediately. If the infection is not treated right away, life-threatening complications may
occur.
Neutropenic fever is most often treated with antibiotics that are known to fight a wide range of infections.
Other medications may be used if another type of infection is suspected. For example, your doctor may
suspect a fungal infection based on your history.
Tests to identify specific infectious agents can take a few days to complete. Your medication may be changed
based on the test results to best treat the infection.
Prevention
Some with neutropenia have a high risk for developing infection. Preventive antibiotics may be prescribed to
help stop infections before they develop.
Other steps include general infection precautions, such as:
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Practicing good hand washing techniques.
Avoiding contact with people who are sick.
Keeping flu and pneumonia vaccines up to date.
Last Reviewed: September 2015 James Cornell, MD
Updated: 10/8/2015
Published by EBSCO Publishing. This content is reviewed regularly and is updated when new and relevant
evidence is made available. This information is neither intended nor implied to be a substitute for professional
medical advice. Always seek the advice of your physician or other qualified health provider prior to starting
any new treatment or with questions regarding a medical condition.