Febrile Neutropenia

Question 1

What is febrile neutropenia defined as?

Answer 1

A neutrophil count lower than 500 per mm^3, or a patient with 1000 per mm^3, with falling counts.

Question 2

What are the clinical signs of neutropenic sepsis?

Answer 2

A fever of greater than 37.5 degree for more than 1 hour.
Rising CRP.
Elevated CRP.
Less than 500 neutrophils per mm^3 (or 0.5x10^9/L).
Other clinical signs of infection.

Question 3

What are the recommended investigations for neutropenic sepsis?

Answer 3

Blood and urine cultures.
Chest X-ray.
Swabs of infected sites.

Question 4

What is the first line treatment for febrile neutropenia?

Answer 4

IV piperacillin and tazobactam.

Question 5

What treatment should be given if penicillin allergic or a Hickman line is inserted?

Answer 5

In penicillin allergic, give IV meropenem.
If they have a Hickman line, give IV vancomycin, as well.

Question 6

What are some causes of febrile neutropenia?

Answer 6

Chemotherapy.
Leukaemia, bone marrow disorders, and other conditions that affect neutrophil production.