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Definition

A neutropenic fever is a temperature over 100.4°F (38°C) in a person with neutropenia. Neutropenia is when you have a low number of neutrophils in the blood. This is a type of white blood cell that helps the body fight infections.

White Blood Cells
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Causes

The fever is caused by an infection.

Neutropenia can have a number of causes. It is often caused by cancer treatments. Other medicine, infections, or cancer itself may also be the cause.

Risk Factors

Having neutropenia raises the chance of infection and fever. It is also more common in older adults.

Factors that raise you risk of a severe infection with neutropenia include:

  • Uncontrolled cancer
  • Chronic obstructive pulmonary disease (COPD)
  • Liver or kidney problems

Symptoms

The main sign is a fever. In some cases, it may be the only sign. Chills and sweating may also be present.

Diagnosis

You will be asked about your symptoms and recent health. A physical exam will be done.

Your blood may be tested.

You may have more tests to look for the site of the infection.

Treatment

An infection with neuropenia can be very dangerous. Early treatment is important. Antibiotics will be started right away.

Tests to find the cause of your infection can take a few days. Your medicine may be changed based on the results.

Prevention

Some people with this health problem are at high risk for infection. Antibiotics may be given to help stop an infection before it happens.

Other steps to decrease the risk of infections include:

  • Practice good hand washing habits.
  • Stay away from people who are sick.
  • Get flu and pneumonia vaccines on time. Ask your doctor about when you should get them.
RESOURCES:

American Cancer Society
http://www.cancer.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

Book L. Neutropenic fever following chemotherapy in a patient with lymphoma. Oncol Nurs Forum. 2008;35(6):885-887.

Febrile neutropenia. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T903015/Febrile-neutropenia#History-and-Physical. Updated April 24, 2018. Accessed July 20, 2018.

Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52(4):427-431.

Infections in people with cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/002871-pdf.pdf. Accessed July 20, 2018.

Last reviewed June 2018 by James Cornell, MD  Last Updated: 7/20/2018