Neutropenic Fever

Abstract

Audience: This oral boards case is appropriate for all emergency medicine learners (residents and interns). Introduction: Neutropenia is a common oncologic emergency, and it frequently develops as a result of myelosuppression from chemotherapy. Neutropenia is defined as absolute neutrophil count (ANC) <1000/mm3, with severe neutropenia being defined as ANC<500/mm3. Patients with fever and neutropenia should be presumed to have infectious etiology and started on antibiotics immediately. The 48-hour mortality associated with an untreated infection is 20%-50%. Objectives: At the end of this oral boards session, the learner will: 1) Appropriately assess a potentially ill patient in oral boards format; 2) order appropriate imaging and labs for a patient with suspected neutropenic fever; 3) consent patient for lumbar puncture and describe how to perform the procedure; 4) execute management and disposition of a patient with neutropenic fever. Method: Oral boards case.

Keywords

• Neutropenic fever
• chemotherapy
• oncology
• infectious disease
• sepsis