Neutropenic Sepsis Flashcards
What is neutropenic sepsis?
Development of sepsis in a patient with neutropenia receiving anti cancer therapy
What is the diagnostic criteria for neutropenic sepsis?
Temperature > 38 degrees
Neutrophil count < 0.5 x 109 /L
Give 2 congenital causes of neutropenic sepsis
Ethnic variation
Cyclical neutropenia in children
(both VERY RARE)
List 3 categories of acquired causes of neutropenic sepsis
Decreased/ineffective neutrophil production: bone marrow infiltration, aplastic anaemia, B12/folate deficiency, chemotherapy, radiotherapy
Accelerated turnover: Felty’s syndrome, hypersplenism, malaria
Others: toxoplasmosis, dengue fever
What is febrile neutropenia?
temperature > 38.5 or 2 consecutive readings of > 38 for 2 hours + an absolute neutrophil count < 0.5 x 109 /L
List 5 risk factors for neutropenic sepsis
Age Poor performance status Poor nutritional status Underlying haem malignancy Intesnsity of chemo
Describe the epidemiology of neutropenic sepsis
Most common in patients with cytotoxic chemotherapy
List 8 signs of neutropenic sepsis
Signs of infection may be minimal Pyrexia Features of infective endocarditis Lymphadenopathy Skin rashes Tachycardia Tachypnoea Altered mental status Poor cap refill/ cyanosis/ other signs of circ insufficiency
List 4 symptoms of neutropenic sepsis
generally unwell fever shivering Sweating Dizziness
Why may patients with neutropenic sepsis not present with a fever?
May be on anti-pyretic medications or steroids
What should be checked for in the history, making a patient more susceptible to neutropenic sepsis?
Active cancer Recent chemotherapy Immunosuppressants or immunosuppressive illness (e.g. HIV) Chronic kidney disease Recent blood products IV devices (e.g. central line)
