Neutropenic sepsis

• Neutropenic sepsis is a potentially life-threatening complication of neutropenia (low neutrophil count).
• It is defined as a temperature of greater than 38°C or any symptoms and/or signs of sepsis, in a person with an absolute neutrophil count of 0.5 x 109/L or lower.
• • Sepsis is a syndrome defined as life-threatening organ dysfunction due to a dysregulated host response to infection.
• • Febrile neutropenia is the most common complication of anticancer treatment, and describes the presence of fever in a person with neutropenia.
• There are multiple possible causes of neutropenia such as cytotoxic chemotherapy and other immunosuppressive drugs, stem cell transplantation, infections, bone marrow disorders such as aplastic anaemia and myelodysplastic syndromes, and nutritional deficiencies.
• • Possible complications of neutropenic sepsis include organ failure, invasive and atypical infection, coagulopathy, encephalopathy and delirium, psychological sequelae and death. 
• A diagnosis of neutropenic sepsis should be suspected in any person with known neutropenia or risk factors for neutropenia, and/or risk factors for neutropenic sepsis, who:

  • Has symptoms or signs indicating possible infection.
  • Becomes unwell.
  • Has a temperature greater than 38°C.
  • Has clinical features of possible sepsis.
  • Has concern from a relative or carer that there is a change in appearance or behaviour.
• Management of a person with suspected neutropenic sepsis should include implementation of the 'Sepsis Six' bundle of care within the first hour following recognition of sepsis.