Neutropenic sepsis: case reportA 66-year-old woman developed neutropenic sepsis during treatment with belotecan for relapsed primary peritoneal serous carcinoma.The woman was treated with one cycle of chemotherapy comprising belotecan 0.3 mg/m2 [route not stated] on days 1 to 5 and cisplatin on day 1. Twelve days after beginning this chemotherapy regimen, her white blood cell (WBC) count was 2150/µL and her absolute neutrophil count (ANC) was 220/µL.The woman received granulocyte colony-stimulating factor but her ANC decreased further to 10/µL. After 5 days with consistent neutropenia (grade 4), her blood pressure decreased to 70/50 mmHg and her body temperature was 38.0°C. She was transferred to the ICU and treated for septic shock. She received antibiotics and antifungal therapy. Her ANC returned to 2060/µL 7 days after neutropenia occurrence. Her body temperature and BP normalised. She recovered gradually from her neutropenic sepsis.Author comment: "[O]ur patient suffered from neutropenic sepsis after belotecan chemotherapy. We have concluded that careful patient selection is warranted for this regimen, and as there is a large possibility of neutropenia, meticulous nadir care is also required".Lee GJ, et al. Durable response after just one cycle of belotecan-based chemotherapy in a patient with relapsed primary peritoneal serous carcinoma.