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Approach and Management of Severe Infections in Neutropenic Patients

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Infectious Diseases in the Intensive Care Unit

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Abstract

Humanity has three great enemies: fever, famine, and war (Bryan 1996) and fever by far is the greatest and the most terrible of the three. Fever is the defining event of severe infection and defining fever has been a major challenge with different proposed thresholds. The mean oral temperature in health is 98.2 °F, with a range of 96 °F–100.8 °F and a slight diurnal variation (Mackowiak et al. 1992). Fever, as defined by the Society of Critical Care Medicine and the Infectious Disease Society of America, is an oral temperature of above 101 °F (O’Grady et al. 1998). Fever in a neutropenic patient has different defining thresholds. Febrile neutropenia is defined by a single oral temperature of 101 °F or a temperature of more than 100.4 °F sustained over a period of 1 h. Axillary temperature may not reflect core body temperature and rectal temperature measurement may result in colonizing of gut commensal into the surrounding mucosa, and hence both are discouraged (Freifeld et al. 2011). The defining temperature threshold at times rests at the intensivist’s discretion and the clinical condition of the patient.

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  1. Department of Hematology, NRS Medical College, Kolkata, India

    Prantar Chakrabarti

  2. Apollo CBCC Hospital, Ahmedabad, India

    Ankit Kumar Jitani

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  1. Department of Medicine, All India Institute of Medical Sciences, New Delhi, India

    Manish Soneja

  2. Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India

    Puneet Khanna

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Chakrabarti, P., Jitani, A.K. (2020). Approach and Management of Severe Infections in Neutropenic Patients. In: Soneja, M., Khanna, P. (eds) Infectious Diseases in the Intensive Care Unit. Springer, Singapore. https://doi.org/10.1007/978-981-15-4039-4_14

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