EM Cases · Immunocompromised host and febrile neutropenia
Febrile neutropenia — septic shock and line infection resus station
ACEM Fellowship OSCE resus station testing FN recognition, 60-minute antibiotics with real doses, cultures from line and periphery, early noradrenaline, and no DRE.
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Target exams
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Prompt
A chemotherapy patient arrives febrile and hypotensive with a tunnelled central line; the nurse suggests waiting for the neutrophil count before antibiotics.
Station brief
Format. Clinical-management (resus) station, 11 minutes. You are the EM consultant.
References4ShowHide
- [2]Taplitz RA, Kennedy EB, Bow EJ, et al. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update. Journal of Clinical Oncology, 2018.PMID 29461916
- [4]Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Intensive Care Medicine, 2021.PMID 34599691
- [6]Feghali F, Aoun C, Kabbara WK Evaluation of the Management of Febrile Neutropenia in a Tertiary Care Center. The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale, 2025.PMID 40236690
- [8]Lehrnbecher T, Robinson PD, Ammann RA, et al. Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023.PMID 36689694