Infection in the neutropenic patient

Abstract

This chapter discusses infection in the neutropenic patient. Patients receiving chemotherapy are at high risk for developing neutropenia and severe infections when their neutrophil count is depressed. Given the lack of inflammatory cells associated with neutropenia, signs of infection may be subtle. Some patients may not mount a fever at all, and the presence of hypotension, tachycardia, or delirium may be the only presenting features of infection. By its very nature, neutropenic fever occurs in those who are immunologically vulnerable and often carry significant infectious comorbidities, such as central venous access, breakdown of the body's physical barriers to infection, and nutritional deficiencies. Therefore, it is not surprising that febrile neutropenia carries significant morbidity and mortality. Researchers have been investigating modalities to help prevent febrile neutropenia, such as the use of colony-stimulating factors, dietary changes, and infection control measures. The chapter focuses on the main causes of infections in febrile neutropenia and selection of antimicrobial therapies.