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Book

Febrile Neutropenia

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
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Book

Febrile Neutropenia

Sheena Punnapuzha et al.
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Excerpt

Neutropenic fever is when there is a single oral temperature greater than or equal to 101 F (38.3 C) or a temperature greater than or equal to 100.4 F (38 C) for at least an hour, with an absolute neutrophilic count (ANC) of less than 1500 cells/microliter. In severe neutropenia, the ANC is less than 500 per microliter. In profound neutropenia, the ANC is less than 100 cells/microliter. The risk of bacteremia increases with profound neutropenia. To calculate ANC, multiply the total white blood cell (WBC) count by the percentage of polymorphonuclear cells (PMNs) and band neutrophils.

  1. ANC = WBC (cells/microL) x percent (PMNs + bands) / 100

Following hematological terms are commonly employed to classify abnormal neutrophil counts:

  1. ANC <200 cells/microL: agranulocytosis

  2. Neutropenia for > three months: chronic neutropenia

  3. Neutropenia without associated anemia and/or thrombocytopenia: isolated neutropenia

  4. Reduced number of neutrophils, eosinophils, and basophils: granulocytopenia

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Conflict of interest statement

Disclosure: Sheena Punnapuzha declares no relevant financial relationships with ineligible companies.

Disclosure: Paul Edemobi declares no relevant financial relationships with ineligible companies.

Disclosure: Amr Elmoheen declares no relevant financial relationships with ineligible companies.

References

    1. Villafuerte-Gutierrez P, Villalon L, Losa JE, Henriquez-Camacho C. Treatment of febrile neutropenia and prophylaxis in hematologic malignancies: a critical review and update. Adv Hematol. 2014;2014:986938. - PMC - PubMed
    1. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, Raad II, Rolston KV, Young JA, Wingard JR, Infectious Diseases Society of America Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011 Feb 15;52(4):e56-93. - PubMed
    1. Rivera-Salgado D, Valverde-Muñoz K, Ávila-Agüero ML. [Febrile neutropenia in cancer patients: management in the emergency room]. Rev Chilena Infectol. 2018;35(1):62-71. - PubMed
    1. Hakim H, Flynn PM, Knapp KM, Srivastava DK, Gaur AH. Etiology and clinical course of febrile neutropenia in children with cancer. J Pediatr Hematol Oncol. 2009 Sep;31(9):623-9. - PMC - PubMed
    1. Holland T, Fowler VG, Shelburne SA. Invasive gram-positive bacterial infection in cancer patients. Clin Infect Dis. 2014 Nov 15;59 Suppl 5(Suppl 5):S331-4. - PMC - PubMed

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