REBEL Cast REBEL Core Cast 122.0 – Neutropenic Fever
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May 15, 2024 Neutropenic fever poses serious risks, especially for chemotherapy patients. The podcast discusses its causes, emphasizing that the body's own flora can be the biggest threat. Quick administration of broad-spectrum antibiotics is crucial in reducing mortality. Additionally, management strategies such as initial resuscitation and collaboration with infection specialists are highlighted. The shift in infection prevalence from gram-negative to gram-positive is another important point, making vigilant monitoring essential.
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Neutropenia & Fever Definition
- Neutropenia is defined as an absolute neutrophil count less than 500 or falling to less than 500 soon.
- Fever with neutropenia signals high risk for rapid serious infection due to immune suppression.
High Mortality Without Antibiotics
- Neutropenic fever occurs frequently in chemotherapy patients with high mortality without antibiotics.
- Early antibiotic administration drastically reduces mortality, emphasizing urgency in treatment.
Changing Pathogens in Neutropenic Fever
- The cause of neutropenic fever shifted from mostly gram-negative to gram-positive bacteria due to prophylactic antibiotic use.
- Emerging resistance is pushing some cases to revert back to gram-negative causes, impacting antibiotic choices.
Take Home Points: There are many causes of neutropenia, chemotherapy being by far the most dangerous. Febrile neutropenia is a condition conveying high mortality. Early administration of antibiotics is the only factor known to reduce this mortality. For a patient with neutropenic fever, remember that the body’s own flora is the greatest danger. Isolate, but ...