Neutropenic Sepsis Flashcards
1
Q
What is Neutropenic Sepsis?
A
A Neutrophil count below 0.5 in a patient who is having anticancer treatment with either a fever (above 38) or other signs/symptoms consistent with clinically significant sepsis.
2
Q
Risk Factors of Neutropenic Sepsis (4).
A
- Sustained Significant Neutropenia expected to last 7+ days.
- Clinically Unstable.
- Underlying Malignancy treated with High-Intensity Chemo.
- Significant Co-Morbidities.
3
Q
Aetiology of Neutropenic Sepsis.
A
Common complication of cancer chemotherapy, occurring 7-14 days after chemotherapy.
4
Q
Prophylaxis of Neutropenic Sepsis.
A
Offer fluroquinolone to patients at risk.
5
Q
Investigations of Neutropenic Sepsis (4).
A
- 2 Sets of Blood Cultures.
- Swabs from Indwelling Lines.
- Bloods, CXR, Serology, PCR.
- System-Based Examinations (but no DRE until antibiotics given).
6
Q
Management of Neutropenic Sepsis (6).
A
- Low-Risk : Oral Antibiotics - Quinolone + Co-Amoxiclav.
- Most : Empirical IV Tazocin + Coverage for MRSA/Gram-Negatives.
- If with Pneumonia : Macrolide.
- Daily Measures of Fever and Baseline Bloods.
- If persisting 48+ Hours, Meropenem +/- Vancomycin.
- If persisting 4-6 days, investigate for fungal infection.
7
Q
What features suggest low-risk? (4)
A
- Haemodynamically Stable.
- No Acute Leukaemia.
- No Organ Failure.
- No Soft Tissue Infection.
- No Indwelling Lines.
8
Q
When are antibiotics stopped?
A
Neutrophil count is normalised and afebrile for 48 hours and normalised bloods.