21st June 2023

Diagnosis

Neutropenic sepsis is diagnosed in patients who have a neutrophil count of ≤ 0.5 x 10⁹/litre with a temperature ≥38.0℃ (or <36.0℃) and/or with features suggestive of sepsis. It is a potentially fatal complication of systemic anticancer therapy or for those living with bone marrow failure. It should be suspected in patients with the aforementioned signs and symptoms in those who have undergone chemotherapy within the preceding 4-30 days. However, the risk is highest between days 7-12 after chemotherapy.

Historical mortality rates of between 2-21% resulted in the ‘National Confidential Inquiry into Patient Outcome and Death – Systemic anticancer therapy: For better or worse?’ report in 2008. This, and subsequent reports, highlighted deficiencies in the provision of care for patients undergoing chemotherapy in the management of neutropenic sepsis, resulting in avoidable deaths. This led to the provision of 24-hour contact numbers for patients to report symptoms and for the provision of emergency empirical antibiotic treatment.