Symptoms and Signs of Neutropenic Sepsis

What are the Symptoms and Signs of Neutropenic Sepsis?

Some of the characteristic symptoms that predict the presence of neutropenic sepsis are:

• Falling neutrophil count � > 0.5 x 10⁹/litre
• Irregular heartbeat�either > 20 beats per month (bpm) or > 90 bpm
• Low or high fever �either < 36�C or > 38�C

• Sore throat
• Flu-like symptoms
• Reduced tension (hypotension)�A reduction of more than 40 mm Hg or blood pressure that is < 90 mm Hg
• Chills
• Mental state is affected
• Feeling generally unwell and listless
• Inflammation of the skin and mucous membranes
• High glucose levels > 110 mg/dL

References:

1. Penack O, Becker C, Buchheidt D, et al. Management of sepsis in neutropenic patients: 2014 updated guidelines from the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO). Ann Hematol. 2014;93(7):1083-95.
2. Kruse JM et al., �Neutropenic Sepsis in the ICU: Outcome Predictors in a Two-Phase Model and Microbiology Findings,� Critical Care Res and Pract. 2016;2016, Article ID 8137850, 9 pages. - (https://doi.org/10.1155/2016/8137850)
3. Clarke RT et al. Neutropenic sepsis: management and complications. Clin Med. 2013;13(2):185-187.
4. Bate J et al. Neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients (NICE Clinical GuidelineCG151). Arch Dis in Childhood � Ed and Pract. 2013;98:73-75.
5. O. Penack, D. Buchheidt, M. Christopeit, M. von Lilienfeld-Toal, G. Massenkeil, M. Hentrich, H. Salwender, H.-H. Wolf, H. Ostermann; Management of sepsis in neutropenic patients: guidelines from the infectious diseases working party of the German Society of Hematology and Oncology, Annals of Oncol. 2011;Vol 22(5):1019�1029.
6. Ramzi J et al. Predictive factors of septic shock and mortality in neutropenic patients. Hematology. 2007;12(6):543-548.
7. Prevention and Management of Neutropenic Sepsis in Cancer Patients. - (https://www.ncbi.nlm.nih.gov/books/NBK373673/)
8. Neutropenic sepsis: prevention and management in people with cancer - (https://www.nice.org.uk/guidance/cg151/chapter/Introduction)
9. National Collaborating Centre for Cancer. Neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients. 2012. - (https://www.nice.org.uk/guidance/cg151/evidence/evidence-review-pdf-188303582)
10. Mapes D. Hutch news: After chemotherapy, immune system recovery may be slower than believed. Updated Jan 26, 2016. Accessed Mar 18, 2019. - (https://www.fredhutch.org/en/news/center-news/2016/01/chemotherapy-immune-system.html)

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