ICU Cases · Antimicrobial therapy
Hot case — the bedside: the febrile neutropenia
A CICM hot case on the febrile neutropenia — the immediate empirical antibiotic (the anti-pseudomonal beta-lactam), the source search, the septic shock resuscitation, and the escalation to the broad cover if unstable.
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Prompt
At the bedside of a chemotherapy patient with a neutrophil count of 0.3 and a new fever. Assess and manage the emergency.
Presentation
You are called to the bedside of a 55-year-old woman on the chemotherapy for an acute leukaemia. Her neutrophil count is 0.3 x 10^9/L, she has developed the fever of 38.5 within the last hour, and she is hypotensive at 88/50.[1]
References2ShowHide
- [1]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [2]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.