Fever and Neutropenia

Lisa A. Spacek, M.D., Ph.D.
Fever and Neutropenia is a topic covered in the Johns Hopkins ABX Guide.

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DEFINITION

  • Febrile neutropenia[8]
    • Fever: single oral temp ≥38.3°C (101°F) or temp ≥38°C (100.4°F) sustained for 1h AND
    • Neutropenia: absolute neutrophil count (ANC) ≤500 cells/mm3 OR ANC predicted to decrease to ≤500 cells/mm3 in 48h
  • Neutrophils create host responses, especially to bacterial and fungal infections. The depth and duration of neutropenia determine the degree of immunocompromise.[2]
  • Caveat: Course may be fulminant, and signs and symptoms typical of bacterial infection (i.e., induration, erythema, pustulation, CXR infiltrates, CSF pleocytosis) may be absent.
  • The mortality rate is as high as 50% in those presenting to the hospital with severe sepsis or shock.

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DEFINITION

  • Febrile neutropenia[8]
    • Fever: single oral temp ≥38.3°C (101°F) or temp ≥38°C (100.4°F) sustained for 1h AND
    • Neutropenia: absolute neutrophil count (ANC) ≤500 cells/mm3 OR ANC predicted to decrease to ≤500 cells/mm3 in 48h
  • Neutrophils create host responses, especially to bacterial and fungal infections. The depth and duration of neutropenia determine the degree of immunocompromise.[2]
  • Caveat: Course may be fulminant, and signs and symptoms typical of bacterial infection (i.e., induration, erythema, pustulation, CXR infiltrates, CSF pleocytosis) may be absent.
  • The mortality rate is as high as 50% in those presenting to the hospital with severe sepsis or shock.

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Last updated: January 13, 2023