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Neutropenic sepsis

Neutropenia febrilis (sepsis neutropenica) · Neutropenická sepse

What it is

Chemotherapy strips the neutrophils; a fever then becomes an emergency.

Symptoms & signs

  • Fever after chemotherapy
  • rigors
  • collapse
  • often no localising signs at all

🚩 Get help if…

  • call 112 / 911 now Fever of 38 °C or more within weeks of chemotherapy
  • call 112 / 911 now Shivering, fast breathing or feeling faint
  • call 112 / 911 now Confusion or cold, mottled skin
  • see a doctor soon Sore mouth, cough or burning on passing urine during treatment

Where it strikes

Medical treatment

  • IV antibiotics within one hour of arrival
  • blood cultures
  • G-CSF
  • source control
  • ICU if unstable
  • trilaciclib (Cosela) before chemotherapy for small-cell lung cancer — FDA-approved 2021 to protect the marrow

Natural & lifestyle

  • Temperature checks at home
  • avoid raw high-risk foods during nadir
  • hand hygiene
  • acute oncology hotline numbers

Emerging & experimental

  • Home-based IV protocols

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • The 'neutropenic diet' (no raw fruit or vegetables) — trials found no fewer infections not confirmed in trials
  • Astragalus — small Chinese trials of faster count recovery early / small studies

ICD codes