Haemological: Neutropenic Sepsis

Question 1

What is neutropenic sepsis?

Answer 1

Neutropenic pt (neutrophil count <1x10 to 9 /L) who is:

• Pyrexial
• new onset of confusion
• tachycardia
• hypotension
• dyspnoea
• hypothermia

Question 2

What investigations would you conduct for a suspected neutropenic sepsis?

Answer 2

Bloods: FBC, WCC, CRP, U&E, LFTs, clotting, cultures

Chest X-RAY

Microbiology: cultures from: bloods, central lines, sputum, urine, stool of diarrhoea

Question 3

What antibiotic therapy would you treat a suspected neutropenic sepsis with?

Answer 3

• start empirical IV antibiotic
• add vancomycin if clinical deterioration
• subsequent treatment is adjusted on the basis of cultures organisms
• swap your oral antibiotics when apyrexial for 48 hours and continue for 10-14 days