Fever and Neutropenia (Assessment and Plan)

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