Initial Management of Fever and Neutropenia: A Practical Approach

Fever in the setting of neutropenia is one of the most common complications of cancer treatment in children. Given the potential morbidity and mortality, these patients need urgent evaluation with a special focus on key areas of susceptibility, remembering that they may not show the typical signs or symptoms of an infection. Prompt recognition of sepsis is vital to ensure that appropriate management occurs in an expedited manner to prevent further deterioration. Rapid administration of broad-spectrum antibiotics is the cornerstone of management, along with fluid resuscitation and other supportive care measures based on the patient's clinical status. This article provides a practical approach to the emergency department management of fever and neutropenia in the pediatric patient.