Febrile neutropenia

Last updated: Tuesday, 30, November, 2010
Key InformationAppropriate Tests
The causative organisms of fever presenting in the patient with underlying neutrophenia are listed.

FBC with diferential WCC; blood culture

See also Neutrophenia for cause of netrophenia; infection (increased susceptibility)

Bacterial Septicaemia, especially

  • Pseudomonas aeruginosa
  • Clostridium perfringens
  • Other Gram - negative Bacilli
  • Staphylococcus aureus

Pneumonia, especially

  • Streptococcus pneumoniae
  • Haemophilus influenzae

 

See Haemophilus influenzae infection

Lung infiltrate, Nodules, especially

  • Aspergillus spp

Bronchial brush, wash: bronchoalveolar lavage if response to appropriate empirical antibiotic regimen has not occurred. Consider CT Guided biopsy.

See Aspergillosis

Mouth, oesophageal ulceration, especially

  • Candida albicans
  • Herpes simplex virus
  • Cytomegalovirus

If response to initial therapy is unsatisfactory: endoscopy with biopsy for microscopy, culture for yeasts, viral detection, culture.

See Candidiasis
See Herpes simplex virus infection
See Cytomegalovirus infection.

Cellulitis, especially

Cannula site infection, especially

  • Staphylococcus aureus
  • Corynebacterium jeikeium
  • Streptococci

Wound swab of cannula site. Culture tip of intravenous cannula.