Febrile neutropenia resident survival guide: Difference between revisions
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{{familytree | | | C01 | | | | | | | | |!| |C01= }} | {{familytree | | | C01 | | | | | | | | |!| |C01= Absolute neutrophil count <500 for ≤7 days<br> no active comorbidities <br> no evidence of end organ dysfunction. Patients recieving chemotherapy for solid tumors are usually considered low risk. | ||
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==Do's== | ==Do's== | ||
* '''Low risk patients for serious complications''' - Patients expected to be neutropenic (absolute neutrophil count [ANC] <500 cells/microL) for ≤7 days with no active comorbidities or evidence of end organ dysfunction. Patients recieving chemotherapy for solid tumors are usually considered low risk. | * '''Low risk patients for serious complications''' - Patients expected to be neutropenic (absolute neutrophil count [ANC] <500 cells/microL) for ≤7 days with no active comorbidities or evidence of end organ dysfunction. Patients recieving chemotherapy for solid tumors are usually considered low risk. | ||
Revision as of 20:38, 3 December 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Definition
Fever in a neutropenic patients is defined as one oral temperature of >38.3°C (101°F) or a temperature of >38.0°C (100.4°F) for >1 hour. Neutropenia is defined as an absolute neutrophil count (ANC) <1500 cells/microL. Severe neutropenia is defined when the ANC <500 cells/microL, or an ANC that is expected to decrease to <500 cells/microL over the next 48 hours. Clinically significant infections usually occurs with severe neutropenia
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Management
Shown below is an algorithm summarizing the approach to [[disease name]].
| Fever > 101 or > 100.4 sustained for 1 hour in patient with ANC <1500 | |||||||||||||||||||||||||||||||||
| Low risk of serious complications | High risk of serious complications | ||||||||||||||||||||||||||||||||
| Absolute neutrophil count <500 for ≤7 days no active comorbidities no evidence of end organ dysfunction. Patients recieving chemotherapy for solid tumors are usually considered low risk. | |||||||||||||||||||||||||||||||||
Do's
- Low risk patients for serious complications - Patients expected to be neutropenic (absolute neutrophil count [ANC] <500 cells/microL) for ≤7 days with no active comorbidities or evidence of end organ dysfunction. Patients recieving chemotherapy for solid tumors are usually considered low risk.
- High risk patients for serious complications- Patients expected to be neutropenic (absolute neutrophil count [ANC] <500 cells/microL) for >7 days with active comorbidities or evidence of end organ dysfunction. Patients recieving myeloablative hematopoietic cell transplantation, and in patients undergoing induction chemotherapy for acute leukemia are considered high risks.