Infection in Neutropenics
Persistent Fever

Persistent Fever

Note

Review microbiologic data to ensure there is no drug-bug mismatch. If a pathogen has been recovered that explains the presentation, therapy can be narrowed accordingly

Repeat blood cultures q48 hours until resolution of fever

If a clinical syndrome becomes evident, modify therapy as per the syndrome, with collection of appropriate samples to identify the organism

The median time for fever to subside is 5 days in hematologic malignancy and 2 days in solid organ tumors

Noninfectious causes of fever should be considered including underlying malignancy, drug fever, venous thrombosis, and others

Candida and Aspergillus species account for most invasive fungal infection in neutropenic patients

Patients determined to be lower risk febrile neutropenia have a low risk of invasive fungal infection and generally should not receive empirical antifungals

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