Health Dictionary
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Fever and Neutropenia (Assessment and Plan)
Introduction
Author: William J Gibson MD, PhD
# Fever and neutropenia
ANC<1000, T>101.4F/38C. In most patients, source is gut translocation.
Factors to consider: anticipated duration of neutropenia, prior infections.
Workup sources:consider CT scan for abdominal infection (add metronidazole), pneumonia, skin exam for cellulitis.
Dx:
Blood cultures x2
Tx:
– Cefepime 2g Q8H
– If concern for MRSA (cavitary PNA, cellulitis), add vanc
– If febrile >4 days on cefepime, add micafungin