Ikram A Burney, Syed M Jilani, Tariq Siddiqui, Raymond A Smego.
An Algorithmic approach to the management of Febrile Neutropenia.
Infect Dis J Jan ;10(2):17-21.
Patients with chemotherapy-induced neutropenia (Absolute Neutrophil Count t/ul) are at a high risk of developing infections. Bodey et al showed more than 30 years ago that there was an inverse relationship between the absolute neutrophil count and life-threatening infections. Fever is usually the sole manifestation of infection in such patients. More than 50% of the patients who present with fever, do so without an obvious clinical focus or microbiological cause of infection. Delay of initiation in antibiotic therapy at this stage may result in rapid development of septicemia and hemodynamic compromise. A delay of more than 48 hours in the administration of appropriate antibiotics may result in a mortality rate of approximately 50%. Empiric administration of broad-spectrum antibiotics results in defervescence in 30-70% of cases.
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