Neutropenic Sepsis (1*)

Question 1

What is it defined as?

Who should it be suspected in?

Why should the absence of fever not rule of this diagnosis?

What are some of its complications?

Answer 1

➊ Temperature > 38.5 or any S+S of sepsis in a pt with an absolute neutrophil count < 0.5

➋ Any pt with known neutropenia or risk factors of neutropenia e.g. chemotherapy, who have:
• S+S of an infection
• Chills, shivers, and fever > 38

➌ • These pts may instead present with hypothermia
• Drugs, like ibuprofen and steroids, may mask the fever

➍ Organ failure, Coagulopathy, Encephalopathy, Delirium, Death

Question 2

Which investigations should be done?

How is it managed?

Answer 2

➊ • 2 sets of blood cultures
• Swab any indwelling lines
• Bloods – FBC, CRP, U&E, LFT
• CXR
• Serology and PCR for viruses

➋ • Sepsis 6
• Barrier and Isolate pt