Neutropenic Fever

Neutropenic Fever (infection of the blood) is often seen as a complication associated with chemotherapy. Neutropenic Fever can be also caused by other illnesses or conditions for example renal failure, which can cause the white blood cells to become overwhelmed by toxins in the blood. All cases of Neutropenic Fever are treated as urgent as patients can become very ill very quickly and in some cases this can lead to death. Generally patients will be started on wide spectrum antibiotics until the results of blood and microbiology tests have confirmed the exact nature of the infection. Once the cause has been identified medication can be targeted more efficiently.

A classic symptom of Neutropenic Fever is the development of a fever, commonly in conjunction with signs of infection. The fever is the body’s immune system working extra hard to fight off the infection.

Patients with Neutropenic Fever will show an abnormally low white blood cell count; if the patient is undergoing chemotherapy the drugs used in the treatment suppress the ability of the bone marrow to produce white blood cells. White blood cells are what the body uses to fight infection on a daily basis.

Treatment of Neutropenic Fever with a combination of antibiotics such as ciprofloxacin and co-amoxilav is generally simple and straightforward, with patients making a good recovery within a few days. However patients with the more serious form of Neutropenic Fever known as Neutropenic Sepsis (blood poisoning), have a very high level of toxins in the blood and an extremely low white blood cell count, as a result these patients, tend to be a lot sicker,  and will need a different type of antibiotic treatment, commonly they are treated with carbpenems. The recovery time from Neutropenic Sepsis tends to be longer than that for the patients with the less acute illness. In some cases it may be recommend that the patient continue on a course of antibiotics for some time after the infection has been treated to prevent further infection. Some patients may have to remain on antibiotics for the rest of their lives.

Not all cases of Neutropenic Fever are caused by chemotherapy, other causes can be

• Infiltration of the body by a foreign object – a small splinter of wood or a rose thorn entering the skin while gardening for example.
• Anything which punctures or breaks the skin can allow fungi or bacteria into the body. This also includes sites of an operation or injection. Which is why it is important to make sure the area is treated with an antiseptic and protected until the wound is healed.
• Certain acquired infections such as typhoid and meningitis also have the potential to cause Neutropenic Fever or the more serious Sepsis Neutropenic.
• Renal Failure, when the kidneys are unable to filter toxins out of the bloodstream.
• Immune system suppressing conditions such as HIV.

There are also rare congenital conditions such as Kostmann’s Syndrome and Shwachman – Diamond Syndrome, symptoms of which include high temperature and low white blood cell count. Suffers can go on to develop leukaemia.