2: Oncological Emergencies - Neutropenic Sepsis

Question 1

What is neutropenic sepsis

Answer 1

Neutrophils <0.5 and one of the following:

• T > 38
• Clinical Signs and Symptoms of Sepsis

Question 2

What are 3 risk factors for neutropenic sepsis

Answer 2

• Leukaemia (Risk bone-marrow suppression)
• Chemotherapy
• Immunosupressed

Question 3

When is neutropenic sepsis most common

Answer 3

1-2W after starting chemotherapy

Question 4

What is offered as prophylaxis for neutropenic sepsis

Answer 4

Fluoroquinolone

Question 5

Explain use of granulocyte colony stimulating factor (gCSF)

Answer 5

Give one day post-chemotherapy to increase neutrophils. It has NO role in neutropenic sepsis

Question 6

In suspected neutropenic sepsis what should be initiated

Answer 6

Sepsis-6

Question 7

What is first-line antibiotic for neutropenic sepsis

Answer 7

Tazosin + Amikacin

Question 8

If individual is allergic to penicillin, only exhibiting a rash, what is given as an alternative

Answer 8

Meropenam, Amikacin

Question 9

If individual has severe anaphylaxis allergy to penicillin, what is prescribed

Answer 9

Ciprofloxacin
Tigecycline
Amikacin

Question 10

If neutropenic sepsis has not resolved in 4-6 days what is recommended

Answer 10

Investigate for fungal disease using high-resolution CT prior to giving anti-fungals