Treatment of Neutropenic Fever

No one might be exempted for experiencing fever. In the side of people who undergo chemotherapy, having a fever might signal something serious going on with the body’s defences. Fever can be defined as a state wherein the body’s core temperature is increased than 38ºC or 100.4ºF. The body reacts to the shift of the homeostasis in many forms and one is through fever. Fever is a compensatory response to infection. It tells the individual that he must do something in order to be more responsible in building up a stronger immune system.

Almost 50% of the patients who have cancer may have neutropenic fever at any point of time. When examined closely, the white blood count may come to its lowest point. This means that the normal combating parts of the blood are being defeated by viral or bacterial invasion. With this manifestation, neutropenic fever should be taken into consideration for proper medical management as well as reverse isolation to prevent further infection.

Since chemotherapy includes not only the cancerous cells as well as the healthy cells, it also means that it may weaken the immune system. During chemotherapy, drastic practices were done in order to minimize infection on its minimum. When a patient exhibits flu-like symptoms, it may mean to properly approach it with proper timing to control the culprit.

Diagnostic Evaluation:

  1. Physical assessment must be done together with close monitoring of vital signs. Fever spikes may also mean a round the clock medication of antipyretics. During physical assessment signs of infection must be taken into consideration such as: redness, swelling, pain, fever. Mouth sore or various skin breakouts may also mean that the body is trying to let out the extra heat from it. Dry mouth may also mean dehydration also that accompanies with febrile episodes.
  2. Chemotherapy sessions done as well as succeeding sessions must also be noted. A current chemotherapy may pose the patient to be neutropenic.
  3. A complete blood count is taking in order to evaluate the neutrophils count. An individual must be hospitalized if the neutrophils count is below 500/mm3. Proper antibiotics are given in order to prevent a life-threatening condition called sepsis.
  4. Other laboratory testing can be conducted in order to square down where is the source of the infection. These are blood culture, urinalysis, and throat swab, gram stain testing of blood and body fluids, fecalysis.

Signs and Symptoms:

  1. Cancer pain
  2. Tenderness on parts of the body
  3. Fever
  4. Blood result may come out with lower levels of neutrophils

Medical Management:

  1. Monitor the fever episodes accurately.
  2. Inform the physician when fever levels exceeds 38.5ºC or 100.5ºF.
  3. Take note of the side effects of the chemotherapeutic drugs. Some of it may temporarily lower the white blood cell count.
  4. Assist the individual in bathing using tepid water. Place ice packs on skin folds and pressure points alternating it with a dry cloth in order to prevent a rebound.
  5. Keep hydrated as much as possible.
  6. Comply with the antipyretic medications prescribed by the physician.
  7. If the symptom persists, consult the physician for a direct-to-room admission to the hospital in order to introduce intravenous fluids.

Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

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