Neutropenic sepsis

Question 1

eutropenic sepsis is a relatively common complication of

Answer 1

cancer therapy, usually as a consequence of chemotherap

Question 2

Neutropenic sepsis may be defined as

Answer 2

neutrophil count of < 0.5 * 109 in a patient who is having anticancer treatment and has one of the following:
a temperature higher than 38ºC or
other signs or symptoms consistent with clinically significant sepsis

Question 3

common etiology of neutropenic sepsis?

Answer 3

coagulase-negative, Gram-positive bacteria are the most common cause, particularly Staphylococcus epidermidis
this is probably due to the use of indwelling lines in patients with cancer

Question 4

Prophylaxis

Answer 4

patients are likely to have a neutrophil count of < 0.5 * 109 as a consequence of their treatment they should be offered a fluoroquinolone

Question 5

Mx

Answer 5

started immediately, do not wait for the WBC

empirical antibiotic therapy with piperacillin with tazobactam (Tazocin) immediately

if patients are still febrile and unwell after 48 hours an alternative antibiotic such as meropenem is often prescribed +/- vancomycin

not responding after 4-6 days the Christie guidelines suggest ordering investigations for fungal infections (e.g. HRCT), rather than just starting therapy antifungal therapy blindly