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.

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2
Q

Risk Factors of Neutropenic Sepsis (4).

A
  1. Sustained Significant Neutropenia expected to last 7+ days.
  2. Clinically Unstable.
  3. Underlying Malignancy treated with High-Intensity Chemo.
  4. Significant Co-Morbidities.
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3
Q

Aetiology of Neutropenic Sepsis.

A

Common complication of cancer chemotherapy, occurring 7-14 days after chemotherapy.

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4
Q

Prophylaxis of Neutropenic Sepsis.

A

Offer fluroquinolone to patients at risk.

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5
Q

Investigations of Neutropenic Sepsis (4).

A
  1. 2 Sets of Blood Cultures.
  2. Swabs from Indwelling Lines.
  3. Bloods, CXR, Serology, PCR.
  4. System-Based Examinations (but no DRE until antibiotics given).
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6
Q

Management of Neutropenic Sepsis (6).

A
  1. Low-Risk : Oral Antibiotics - Quinolone + Co-Amoxiclav.
  2. Most : Empirical IV Tazocin + Coverage for MRSA/Gram-Negatives.
  3. If with Pneumonia : Macrolide.
  4. Daily Measures of Fever and Baseline Bloods.
  5. If persisting 48+ Hours, Meropenem +/- Vancomycin.
  6. If persisting 4-6 days, investigate for fungal infection.
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7
Q

What features suggest low-risk? (4)

A
  1. Haemodynamically Stable.
  2. No Acute Leukaemia.
  3. No Organ Failure.
  4. No Soft Tissue Infection.
  5. No Indwelling Lines.
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8
Q

When are antibiotics stopped?

A

Neutrophil count is normalised and afebrile for 48 hours and normalised bloods.

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