Fever and Neutropenia

DEFINITION

• Febrile neutropenia[8]
  
  • Fever: single oral temp ≥38.3°C (101°F) or temp ≥38°C (100.4°F) sustained for 1h AND
  • Neutropenia: absolute neutrophil count (ANC) ≤500 cells/mm³ OR ANC predicted to decrease to ≤500 cells/mm³ in 48h
• Neutrophils create host responses, especially to bacterial and fungal infections. The depth and duration of neutropenia determine the degree of immunocompromise.[2]
• Caveat: Course may be fulminant, and signs and symptoms typical of bacterial infection (i.e., induration, erythema, pustulation, CXR infiltrates, CSF pleocytosis) may be absent.
• The mortality rate is as high as 50% in those presenting to the hospital with severe sepsis or shock.