Neutropenic Sepsis Flashcards
Define Neutropenic Sepsis?
The development of sepsis in a patient with neutropenia
What is the diagnostic criteria for Neutropenic Sepsis?
Temperature > 38 degrees
Neutrophil count < 0.5 x 10^9 /L
When can patients have Neutropenic Sepsis without a fever?
They may be on anti-pyretic medications or steroids
What are the two types of Neutropenic Sepsis?
Incidental Neutropenia
Febrile Neutropenia
What are the two types of cause of Incidental Neutropenia?
Congenital
Acquired
What are the congenital causes of Incidental Neutropenia?
Ethnic Variation
Cyclical Neutropenia in children
ALL Very RARE
What are the acquired causes of Incidental Neutropenia?
Decreased/ineffective neutrophil production
Accelerated turnover
Toxoplasmosis
Dengue Fever
What are some examples of Decreased/Ineffective neutrophil production?
Bone Marrow Infiltration Aplastic Anaemia B12/Folate Deficiency Chemotherapy Radiotherapy
What are some examples of Accelerated Turnover?
Felty’s Syndrome
Hypersplenism
Malaria
What is the definition of Febrile Neutropenia?
Temperature > 38.5 or two consecutive readings of > 38 for two hours and an absolute neutrophil count < 0.5
What is the epidemiology of Neutropenic Sepsis?
Most common in patients with cytotoxic chemotherapy
What do we check the history for in Neutropenic Sepsis?
High risk features: Active Cancer, recent chemotherapy, use of immunosuppressants or immunosuppressive illness (e.g. HIV)
Chronic Kidney Disease
Recent Blood Products
Intravascular devices (e.g. central line)
What findings might you find on Examination of a patient with Neutropenic Sepsis?
Signs of Infection may be minimal
Pyrexia
Features of infective endocardititis
What investigations would you do for Neutropenic Sepsis and why would you do them?
FBC (check neutrophil level) Blood cultures (check for sepsis) Blood Film D-dimer (for DIC) U&Es Creatinine LFTs
