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Introduction

Neutrophils are a crucial component of the rapid-onset innate immune response to invading bacteria and fungi.  As such, patients with neutropenia have increased risk for life-threatening infections.  In this population, fever is considered a medical emergency as it is frequently the earliest and only sign of active infection.

Neutropenic fever is generally defined by:

  • A single oral temperature >38.3 C (101 F) or a persistent temperature >38 C (100.4 F) for 1 hour.
  • An absolute neutrophil count (ANC) <1,500/mm3 (or 1,000/mm3).

Some organizations and institutions have slightly different defining parameters.

Risk factors

Neutropenic fever is most common in patients undergoing cytotoxic chemotherapy for cancer (eg, alkylating agents, antimetabolites) and in those with hematologic malignancies

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