Neutropenic sepsis

Neutropenic sepsisis a clinical condition in which sepsis results from failure of the antibacterial function of the immune system due to severe neutropenia after chemotherapeutic treatment or medullary attenuation for another reason. Sepsis is defined as SIRS (systemic inflammatory response syndrome) with confirmed infection. The term neutropenic sepsis is often used synonymously with the term febrile neutropenia in clinical practice; at other times, neutropenic sepsis may indicate a more severe condition.

Clinical findings

• febrile;
• tachycardia;
• tachypnoe;
• arterial hypotension;
• qualitative and quantitative disorders of consciousness;
• oligo- to anuria;
• increased urea and creatinine;
• low hemoglobin oxygen saturation (SpO₂);
• lactic acidosis.

Therapy

• insertion of 1-2 peripheral cannulas and a central venous catheter;
• monitoring of blood pressure, EGC, SpO₂;
• infusion of 1000 ml of crystalloid solution over 30 min and then according to the current state;
• in case of persistent hypotension application of noradrenaline;
• administration of antibiotics (blood collection for blood culture before their application);
• collection of other relevant biological material (urine, cerebrospinal fluid, BAL fluid, for diarrhea Clostridium difficile).

Sources

Related articles

• Febrile neutropenia
• Sepsis