Neutropenic Fever

Shannon Toohey, MD, MA

doi:https://doi.org/10.21980/J8KW2K

Neutropenic Fever

Shannon Toohey, MD, MA^*

^*University of California, Irvine, Department of Emergency Medicine, Orange, CA

Correspondence should be addressed to Shannon Toohey, MD, MAEd at stoohey@uci.edu

DOI: https://doi.org/10.21980/J8KW2KIssue 1:2

Infectious Disease Oral Boards

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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.

Topics:

Neutropenic fever, chemotherapy, oncology, infectious disease, sepsis.