Neutropenic Sepsis

Neutropenic sepsis is defined as a temperature > 38.5°C or any S+S of sepsis in a patient with an absolute neutrophil count < 0.5. It should be suspected in any patient with known neutropenia or risk factors of neutropenia e.g. chemotherapy, who have:

• S+S of an infection

• Chills, shivers, and fever > 38°C

The absence of fever shouldn't rule out neutropenic sepsis as a diagnosis as:

• These patients may instead present with hypothermia

• Drugs, like ibuprofen and steroids, may mask the fever

Complications - Organ failure, Coagulopathy, Encephalopathy, Delirium, Death

Investigations:

• 2 sets of blood cultures

• Swab any indwelling lines

• Bloods – FBC, CRP, U&E, LFT

• CXR

• Serology and PCR for viruses

Management:

• Sepsis 6

• IV Tazocin (Piperacillin/Tazobactam)

• Barrier and Isolate patient