Febrile Neutropenia
Febrile neutropenia is an oncologic emergency demanding rapid recognition and treatment due to the high risk of severe systemic infection and mortality. It is defined by a fever in a patient who has a significant reduction in the number of circulating neutrophils, the immune system's primary defense against bacterial pathogens. This condition requires immediate intervention to mitigate potential disaster.
The prompt initiation of empirical broad-spectrum antibiotic therapy is the cornerstone of managing this critical condition before specific culture results are available. The lack of adequate immune cells means that infections can progress extremely quickly and overwhelming sepsis is a major concern. Risk stratification tools are routinely used to categorize patients based on expected complications and guide the appropriate setting for subsequent care management and monitoring.
The primary etiology is the myelosuppressive effect of chemotherapy, which inhibits the bone marrow’s ability to produce white blood cells, including neutrophils. When the absolute neutrophil count drops below a critical threshold, the body’s ability to mount a robust defense against common bacteria is severely impaired, turning normally innocuous flora into life-threatening pathogens. The fever itself is often the only initial sign of a serious underlying infection. Diagnostic workup must be swift, involving blood cultures, chest imaging, and assessment of potential sites of infection. The choice of initial antibiotic regimen is guided by local resistance patterns and the patient’s clinical stability, often including agents with activity against Gram-negative bacteria, such as *Pseudomonas aeruginosa*. Prophylactic use of colony-stimulating factors can sometimes be employed in high-risk settings to mitigate the severity and duration of the neutropenic phase. Education for patients undergoing chemotherapy focuses heavily on recognizing the signs of fever and seeking immediate assistance, which is vital for improving outcomes in this time-sensitive medical situation.