A patient on chemotherapy with a temperature of 38.0 degrees or more, or with new rigors or feeling acutely unwell, may have neutropenic sepsis even with no focus on examination. Treat it as an emergency: examine, take cultures and a full blood count, and give broad-spectrum intravenous antibiotics promptly according to local protocol, without waiting for the count to return in a patient who looks unwell.
Tell every patient starting chemotherapy exactly whom to ring and when, and give them a written card with the number. The instruction to come in with a fever, even at night or on a weekend, prevents the delay that makes sepsis dangerous.
- Give every patient a written fever plan and a contact number before chemotherapy starts.
- Treat fever on chemotherapy as possible neutropenic sepsis until proven otherwise.
- Take cultures and a full blood count, then start antibiotics promptly per local protocol.
- Do not wait for the neutrophil count in a patient who looks unwell.
Why it matters
Delay in the first hour or two is what turns a manageable infection into a fatal one.
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