{
  "schemaVersion": 2,
  "eyebrow": "Medical Oncology",
  "title": "Febrile Neutropenia",
  "summary": "Febrile neutropenia is an oncologic emergency requiring immediate empiric antibacterial therapy, focused source evaluation, and disposition based on physiologic stability, anticipated neutropenia, and validated complication-risk assessment.",
  "seoDescription": "Point-of-care approach to febrile neutropenia: diagnostic threshold, urgent empiric antibiotics, risk stratification, outpatient selection, and antifungal escalation.",
  "clinicalQuestion": "How should clinicians rapidly evaluate, risk-stratify, and treat adults and children with febrile neutropenia?",
  "specialty": "Hematology and Oncology",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "febrile neutropenia",
    "neutropenic fever",
    "chemotherapy complications",
    "oncologic emergency",
    "empiric antibiotics",
    "MASCC score",
    "outpatient febrile neutropenia"
  ],
  "keyTakeaways": [
    "Treat fever with ANC 500/µL or lower, or ANC expected to fall to 500/µL or lower within 48 hours, as febrile neutropenia; a single oral temperature of 38.3°C or higher or temperature of 38.0°C or higher sustained for 1 hour meets the fever threshold.[1][19]",
    "Administer empiric antibacterial therapy urgently, within 2 hours of presentation, rather than waiting for culture results or a localizing source.[19]",
    "Use clinical condition, cancer therapy context, baseline studies, and risk assessment to distinguish patients requiring inpatient treatment from carefully selected low-risk candidates for outpatient management.[1][13][23]",
    "Persistent fever after approximately 1 week of broad-spectrum antibacterial therapy during ongoing neutropenia should prompt consideration of empiric antifungal therapy and evaluation for invasive fungal infection.[8][20]",
    "Fever after chemotherapy remains high risk even when a bacterial source is not apparent; recent chemotherapy within 6 weeks should heighten suspicion for treatment-related neutropenia.[15]"
  ],
  "sections": [
    {
      "id": "recognition-and-first-hours",
      "eyebrow": "Immediate action",
      "heading": "Recognize febrile neutropenia and give antibiotics urgently",
      "intro": "Do not defer treatment while confirming an infectious source.",
      "paragraphs": [
        "Diagnose febrile neutropenia when oral temperature is at least 38.3°C (101°F) once, or at least 38.0°C (100.4°F) sustained for 1 hour, with ANC 500/µL or lower, or ANC 1,000/µL or lower that is expected to decrease to 500/µL or lower within 48 hours.[1][19] This threshold includes patients at the anticipated chemotherapy nadir, not only those with an already documented ANC below 500/µL.",
        "Treat febrile neutropenia as an oncologic emergency. Obtain clinically indicated diagnostic specimens promptly, but administer empiric antibacterial therapy within 2 hours of presentation; microbiologic confirmation is not required because many episodes have no identifiable bacterial source despite the need for antibacterial treatment.[1][15][19]",
        "Prioritize physiologic stabilization before outpatient-risk assessment. Hemodynamic instability, respiratory compromise, altered mental status, or other features of critical illness should direct immediate inpatient escalation and broad empiric treatment rather than use of a low-risk pathway. Septic shock and comorbidity substantially increase reported mortality risk in febrile neutropenia.[23]"
      ],
      "bullets": [
        "Confirm temperature method, timing, and peak value; use the oral fever thresholds when applying the standard definition.[1][19]",
        "Calculate ANC and determine whether the count is expected to decline during the next 48 hours.[1][19]",
        "Document timing and type of systemic anticancer therapy; chemotherapy received within 6 weeks of presentation increases the likelihood of treatment-associated neutropenia.[15]",
        "Draw cultures and collect urine, wound, or other site-directed specimens when clinically indicated, but do not allow collection to delay empiric antibiotics.[12][19]"
      ],
      "subsections": [],
      "table": {
        "caption": "Operational diagnostic thresholds for febrile neutropenia.[1][19]",
        "columns": [
          "Finding",
          "Threshold",
          "Clinical action"
        ],
        "rows": [
          [
            "Fever",
            "Single oral temperature ≥38.3°C (101°F), or ≥38.0°C (100.4°F) sustained for 1 hour.[1][19]",
            "Evaluate immediately for febrile neutropenia when neutropenia is present or anticipated.[1][19]"
          ],
          [
            "Established severe neutropenia",
            "ANC ≤500/µL.[1][19]",
            "Treat fever as febrile neutropenia and initiate urgent empiric antibacterial therapy.[19]"
          ],
          [
            "Anticipated severe neutropenia",
            "ANC ≤1,000/µL expected to fall to ≤500/µL within 48 hours.[1][19]",
            "Use the same emergency management pathway as established severe neutropenia.[1][19]"
          ]
        ]
      }
    },
    {
      "id": "initial-evaluation",
      "eyebrow": "Source and severity",
      "heading": "Perform a focused source evaluation without delaying treatment",
      "intro": "Testing should identify instability, an actionable focus, and therapy-limiting organ dysfunction.",
      "paragraphs": [
        "Perform a complete examination targeted to occult infection sites and treatment complications, including the oral cavity, skin and soft tissue, vascular-access sites, perineum, lungs, abdomen, and wounds. In neutropenic patients, local inflammatory findings may be limited; absence of a clear source does not reduce the need for empiric antibacterial treatment.[15][19]",
        "Obtain a complete blood count with differential to establish ANC and assess concurrent cytopenias. Measure renal function, liver tests, and electrolytes because these define acute organ involvement and provide a baseline for antimicrobial selection and subsequent toxicity monitoring. Blood cultures should include a peripheral sample; obtain urine, wound, or pus cultures when those sites are clinically implicated.[12]",
        "Use imaging selectively rather than as a universal screening test. Obtain chest imaging for respiratory symptoms or signs; high-resolution chest CT is used when fungal infection is clinically suspected. In persistent neutropenic fever, imaging and microbiology should be revisited because an initially occult invasive fungal process may emerge after broad-spectrum antibacterial exposure.[12][20]"
      ],
      "bullets": [
        "Bloodstream infection evaluation: obtain peripheral blood culture and add cultures from clinically relevant sites or access devices according to presentation.[12]",
        "Urinary or wound focus: obtain urine culture or wound/pus culture when symptoms, examination, or device findings support that source.[12]",
        "Pulmonary or fungal concern: use chest imaging for clinical pulmonary findings and high-resolution chest CT when invasive fungal infection is suspected.[12]",
        "Biomarkers: procalcitonin has been studied for bacteremia, ICU admission, and mortality prediction, but should complement rather than replace clinical assessment and cultures.[23]"
      ],
      "subsections": [],
      "table": {
        "caption": "Focused initial studies and the decision each study informs.[12][23]",
        "columns": [
          "Study",
          "When to obtain",
          "Decision informed"
        ],
        "rows": [
          [
            "CBC with differential",
            "At presentation.[12]",
            "Confirms ANC category, detects concurrent cytopenias, and establishes a baseline for serial monitoring.[1][12]"
          ],
          [
            "Renal function, liver tests, electrolytes",
            "At presentation.[12]",
            "Identifies organ dysfunction and provides a baseline for antimicrobial selection and monitoring.[12]"
          ],
          [
            "Peripheral blood culture",
            "At presentation before or during urgent treatment workflow.[12][19]",
            "Identifies bacteremia and supports later antimicrobial targeting; do not delay empiric therapy.[19]"
          ],
          [
            "Urine or wound/pus culture",
            "When urinary, wound, or soft-tissue findings are present.[12]",
            "Defines an actionable source and susceptibility profile.[12]"
          ],
          [
            "Chest imaging; high-resolution chest CT",
            "For respiratory findings; use high-resolution CT when fungal infection is suspected.[12]",
            "Identifies pulmonary infection and supports escalation to an invasive fungal infection pathway.[12][20]"
          ]
        ]
      }
    },
    {
      "id": "risk-stratification-and-disposition",
      "eyebrow": "Disposition",
      "heading": "Separate high-risk episodes from selected outpatient candidates",
      "intro": "Clinical stability is the first gate; prediction tools refine, but do not replace, bedside assessment.",
      "paragraphs": [
        "Risk stratification should integrate current clinical condition, cancer type and treatment context, infection history, baseline laboratory and radiographic findings, and anticipated duration or depth of neutropenia. Talcott, MASCC, and CISNE are established adult complication-risk models, but they use different predictors and should be interpreted within the presenting clinical context.[11][13][23]",
        "High-risk management is appropriate for patients with physiologic instability, severe clinical illness, major comorbidity, concerning vital-sign or laboratory abnormalities, or a presentation requiring inpatient diagnostic or supportive care. These patients should receive inpatient empiric antibacterial therapy and serial reassessment for a source, resistance, organ dysfunction, and escalation needs.[11][23]",
        "Outpatient management is a risk-stratified option rather than a default. ASCO/IDSA guidance addresses outpatient treatment in adults with malignancy, and evidence supports reduced-intensity treatment for selected low-risk pediatric episodes; selection depends on a structured low-risk assessment and the ability to safely execute follow-up and reassessment.[1][2][5][13][23]"
      ],
      "bullets": [
        "Do not classify a patient as low risk solely because no source is identified; unknown-source fever is common in febrile neutropenia.[15][21]",
        "Use MASCC, CISNE, or Talcott only after determining that the patient is clinically stable enough for risk-based disposition assessment.[11][23]",
        "Reassess risk when vital signs, organ-function studies, cultures, imaging, or neutrophil trajectory change; a low-risk designation at triage is not permanent.[11][13][23]"
      ],
      "subsections": [
        {
          "heading": "Pediatric episodes",
          "paragraphs": [
            "For children with cancer or hematopoietic stem-cell transplantation, initial assessment similarly relies on history, examination, baseline laboratory and radiologic studies, and clinical condition. Pediatric low-risk pathways can reduce treatment intensity in selected episodes, but require a pediatric oncology-specific risk framework rather than direct application of adult disposition tools.[2][5][13][21]"
          ],
          "bullets": []
        }
      ],
      "table": {
        "caption": "Disposition framework for febrile neutropenia.[11][13][23]",
        "columns": [
          "Clinical branch",
          "Features driving the branch",
          "Next action"
        ],
        "rows": [
          [
            "Unstable or clinically high risk",
            "Critical illness, comorbidity, abnormal vital signs or laboratory findings, or need for inpatient diagnostic and supportive management.[11][23]",
            "Admit, provide urgent empiric antibacterial therapy, and reassess serially for complications and source control needs.[19][23]"
          ],
          [
            "Clinically stable adult",
            "No immediate instability; use clinical context plus an adult complication-risk model such as MASCC, CISNE, or Talcott.[11][23]",
            "Consider outpatient management only if structured assessment supports low risk and safe follow-up is feasible.[1][23]"
          ],
          [
            "Clinically stable child",
            "Use pediatric oncology history, examination, baseline studies, and pediatric risk stratification.[2][5][13]",
            "Use a pediatric oncology-directed reduced-intensity or outpatient pathway only for a validated low-risk episode.[2][5][21]"
          ]
        ]
      }
    },
    {
      "id": "empiric-treatment-and-escalation",
      "eyebrow": "Antimicrobial strategy",
      "heading": "Use empiric antibacterial therapy first, then escalate by trajectory",
      "intro": "Initial therapy is urgent; subsequent changes should follow clinical deterioration, microbiology, and duration of fever.",
      "paragraphs": [
        "All patients meeting febrile neutropenia criteria require urgent empiric antibacterial therapy. The immediate objective is early coverage of likely bacterial pathogens during severe neutrophil impairment, not proof of infection before treatment. The guideline timing target is within 2 hours of presentation.[19]",
        "Antibiotic selection should be informed by risk category, current clinical severity, prior infection history, local resistance patterns, and suspected site of infection. The clinical picture should guide antibiotic choices after risk stratification; culture and susceptibility results then permit narrowing or redirection when an organism or focus is established.[3][12][19]",
        "Persistent fever alone during ongoing neutropenia does not establish antibacterial failure, but it requires repeat assessment for a missed focus, resistant pathogen, drug fever, mucosal-barrier injury, and invasive fungal infection. If fever persists after about 1 week of broad-spectrum antibacterial therapy during neutropenia, add empiric antifungal therapy or pursue a preemptive antifungal strategy guided by clinical and diagnostic findings.[8][20]"
      ],
      "bullets": [
        "At each reassessment, review culture results, renal and hepatic function, new focal findings, and respiratory status before altering therapy.[12][19]",
        "Escalate fungal evaluation when persistent fever is accompanied by pulmonary findings or other clinical suspicion; high-resolution chest CT is a relevant diagnostic test in this branch.[12][20]",
        "Use a documented organism, susceptibility profile, or focal infection to replace purely empiric treatment with targeted therapy when clinically appropriate.[12]"
      ],
      "subsections": [
        {
          "heading": "Persistent fever during neutropenia",
          "paragraphs": [
            "The clinically important timing discriminator is persistent fever after roughly 7 days of broad-spectrum antibacterial treatment in a neutropenic patient. At that point, reassess for invasive candidiasis and other fungal disease and consider empiric antifungal treatment; diagnostic strategy should be intensified when clinical findings suggest a localized fungal process.[8][20]"
          ],
          "bullets": [
            "Repeat focused examination and source-directed cultures when a new localizing sign develops.[12]",
            "Obtain high-resolution chest CT when invasive fungal infection is clinically suspected.[12]",
            "Do not treat persistent fever as a reason to abandon risk assessment; deterioration, organ dysfunction, or new imaging abnormalities changes the treatment setting and diagnostic urgency.[11][20][23]"
          ]
        }
      ],
      "table": {
        "caption": "Trajectory-based management after initial empiric antibacterial therapy.[8][12][19][20]",
        "columns": [
          "Clinical trajectory",
          "Interpretation",
          "Next step"
        ],
        "rows": [
          [
            "At presentation",
            "Febrile neutropenia is an oncologic emergency regardless of whether a source is evident.[1][19]",
            "Obtain indicated cultures and baseline studies, then administer empiric antibacterial therapy within 2 hours.[12][19]"
          ],
          [
            "Culture-positive or source identified",
            "Microbiology or a focal syndrome provides a target for therapy.[12]",
            "Direct treatment to organism susceptibility and site while monitoring clinical response and organ function.[12]"
          ],
          [
            "Persistent fever during ongoing neutropenia",
            "Consider occult source, resistant infection, and invasive fungal infection; fever alone is not microbiologic proof of antibacterial failure.[8][20]",
            "Repeat focused evaluation; use chest CT when fungal infection is suspected.[12][20]"
          ],
          [
            "Persistent fever after about 1 week of broad-spectrum antibiotics",
            "This is the traditional trigger for empiric antifungal treatment in a neutropenic patient.[8]",
            "Add empiric antifungal therapy or use a diagnostic-guided preemptive approach when clinical findings support it.[8][20]"
          ]
        ]
      }
    },
    {
      "id": "monitoring-and-prevention",
      "eyebrow": "Ongoing care",
      "heading": "Monitor for evolving infection and address recurrence risk before the next treatment cycle",
      "intro": "Reassessment is driven by clinical trajectory, organ function, microbiology, and future chemotherapy exposure.",
      "paragraphs": [
        "Monitor serial vital signs, clinical examination findings, ANC trajectory, renal and hepatic function, and culture results. Reassess promptly for new pulmonary, skin, catheter-associated, urinary, abdominal, or wound findings because the source may be absent at presentation and later become clinically apparent.[12][15]",
        "Before the next chemotherapy cycle, review the episode in the context of regimen-associated febrile neutropenia risk and patient factors. Risk for febrile neutropenia varies with chemotherapy regimen intensity and is modified by age, cancer type, comorbidities, prior infection history, delayed antibiotic exposure, and vital-sign or laboratory abnormalities.[11][16][22]",
        "A prior febrile neutropenia episode should prompt coordination between oncology and the treating acute-care team to document the episode’s severity, microbiology, suspected source, duration of neutropenia, and treatment complications. These data determine whether subsequent cycles require modification of the supportive-care plan or more intensive surveillance; the specific intervention should follow the planned regimen and oncology protocol.[11][16]"
      ],
      "bullets": [
        "Trend ANC rather than relying on a single count; anticipated decline to severe neutropenia is part of the diagnostic definition.[1][19]",
        "Trend renal and hepatic studies when antimicrobials are continued or changed because these values establish organ-function trajectory and affect treatment safety.[12]",
        "Record culture-positive events and susceptibility patterns for future empiric-antibiotic selection during recurrent fever episodes.[12][19]"
      ],
      "subsections": [],
      "table": {
        "caption": "Monitoring targets that change reassessment or subsequent-cycle planning.[1][11][12][16][19]",
        "columns": [
          "Target",
          "What to track",
          "Why it changes management"
        ],
        "rows": [
          [
            "Clinical status",
            "Vital signs, respiratory findings, mental status, new focal symptoms, and examination changes.[11][12]",
            "New instability or a focal syndrome requires escalation of diagnostic and treatment intensity.[11][23]"
          ],
          [
            "Hematologic course",
            "Serial ANC and duration of neutropenia.[1][19]",
            "Persistent or anticipated severe neutropenia sustains infection risk and informs ongoing monitoring.[1][19]"
          ],
          [
            "Organ function",
            "Renal function, liver tests, and electrolytes.[12]",
            "Organ dysfunction affects antimicrobial safety and may signal severe infection or treatment toxicity.[12]"
          ],
          [
            "Microbiology",
            "Blood, urine, wound, or other clinically indicated culture results and susceptibilities.[12]",
            "Allows targeted therapy and informs empiric choices in future episodes.[12][19]"
          ],
          [
            "Future chemotherapy risk",
            "Regimen intensity plus patient-specific risk factors and prior febrile neutropenia history.[11][16][22]",
            "Guides oncology planning for subsequent-cycle supportive care and surveillance.[16]"
          ]
        ]
      }
    }
  ],
  "faq": [],
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  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "Febrile neutropenia - Symptoms, diagnosis and treatment | BMJ Best Practice US",
      "detail": "bestpractice.bmj.com",
      "url": "https://bestpractice.bmj.com/topics/en-us/950",
      "authors": "bestpractice.bmj.com",
      "host": "bestpractice.bmj.com",
      "snippet": "Febrile neutropenia is defined as a single oral temperature measurement of ≥101ºF (≥38.3ºC) or a temperature of ≥100.4ºF (≥38.0ºC) sustained over 1 hour, with an absolute neutrophil count (ANC) of ≤500 cells/microliter, or an ANC of ≤1000 cells/microliter that is expected to decrease to ≤500 cells/m",
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    {
      "number": 2,
      "title": "Risk stratification in children with cancer and febrile neutropenia",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/pdfs/journals/eclinm/PIIS2589-5370(19)30219-6.pdf",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "Background: Reduced intensity treatment of low-risk febrile neutropenia (FN) in children with cancer is safe and improves quality of life.",
      "score": 0.41406992
    },
    {
      "number": 3,
      "title": "Impact of time to antibiotics on clinical outcome in ...",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(24)00220-7/fulltext",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "by GM Haeusler · 2024 · Cited by 13 — febrile neutropenia (FN) is standard of care, use the complete clinical picture to risk-stratify and inform antibiotic choices.",
      "score": 0.34753764
    },
    {
      "number": 4,
      "title": "Re-evaluating and recalibrating predictors of bacterial ...",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30138-3/fulltext",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "by GM Haeusler · 2020 · Cited by 40 — Risk stratification in fever and neutropenia (FN), one of the most common complications of childhood cancer care, is recommended in",
      "score": 0.33770624
    },
    {
      "number": 5,
      "title": "Risk stratification in children with cancer and febrile ...",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30219-6/fulltext",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "by GM Haeusler · 2020 · Cited by 62 — Reduced intensity treatment of low-risk febrile neutropenia (FN) in children with cancer is safe and improves quality of life. Identifying children with",
      "score": 0.3300505
    },
    {
      "number": 6,
      "title": "Management of febrile neutropenia in low risk cancer patients",
      "detail": "thorax.bmj.com",
      "url": "https://thorax.bmj.com/content/thoraxjnl/55/suppl_1/S63.full.pdf",
      "authors": "thorax.bmj.com",
      "host": "thorax.bmj.com",
      "snippet": "Background. Among patients with fever and neutropenia during cancer chemotherapy who have a low risk of complications, oral administration of empirical",
      "score": 0.564027
    },
    {
      "number": 7,
      "title": "A Double-Blind Comparison of Empirical Oral and ...",
      "detail": "www.nejm.org",
      "url": "https://www.nejm.org/doi/full/10.1056/NEJM199907293410501",
      "authors": "www.nejm.org",
      "host": "www.nejm.org",
      "snippet": "by A Freifeld · 1999 · Cited by 555 — ... Pseudomonas aeruginosa and most other common pathogens associated with fever in patients with neutropenia. The goal of this study was to",
      "score": 0.32389367
    },
    {
      "number": 8,
      "title": "Management of Fever in Patients with Cancer and ...",
      "detail": "www.nejm.org",
      "url": "https://www.nejm.org/doi/pdf/10.1056/NEJM199305063281808",
      "authors": "www.nejm.org",
      "host": "www.nejm.org",
      "snippet": "by PA Pizzo · 1993 · Cited by 1232 — Add empirical antifungal therapy if a patient with neutropenia remains fe- brile after a week of broad-spectrum antibiotic therapy or has",
      "score": 0.21418184
    },
    {
      "number": 9,
      "title": "Management of Febrile Neutropenia in Pediatric Oncology | Cancer Therapy | Oncology and Carcinogenesis | Health sciences | Topics | Nature Index",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/nature-index/topics/l4/management-of-febrile-neutropenia-in-pediatric-oncology",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "Management of febrile neutropenia in paediatric oncology demands rapid assessment, risk stratification and timely intervention to reduce infection-related morbidity and mortality. Central to practice is the administration of empiric broad-spectrum antibiotics at fever onset in patients with an absol",
      "score": 0.5855047
    },
    {
      "number": 10,
      "title": "Clinical profile, treatment, and outcomes of febrile neutropenia in hematologic disorders: a look at 30-day mortality predictors | Scientific Reports",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-025-06787-z",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "### Laboratory profiles of the study participants\n\nThe total WBC (white blood cell) count on the diagnosis of febrile neutropenia ranged from 100 cells/mm3 to 80,000 cells/mm3, with a median (Q1, Q3) count of 1115 (677.5, 2777.5) cells/mm3. With respect to the ANC count, 55 (41.7%) of the patients h",
      "score": 0.5063723
    },
    {
      "number": 11,
      "title": "In-hospital mortality prognostication for cancer patients with febrile neutropenia | Communications Medicine",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s43856-025-01142-9",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "A sample of 1000 hospitalized cancer patients over the period of 44 months (Aug 2014 to April 2018), recognized for neutropenia sepsis, was collected. Of these patients, 137 (13.7%) were categorized to develop febrile neutropenic sepsis using neutrophil count (<1500/µL), fever ( ≥ 38.3 °C/101 °F) th",
      "score": 0.43784812
    },
    {
      "number": 12,
      "title": "Microbiological profile and 30-day mortality outcomes in febrile neutropenia among solid malignancy patients: a multicentre retrospective study from resource-limited setting | Scientific Reports",
      "detail": "www.nature.com",
      "url": "https://www.nature.com/articles/s41598-025-22761-1",
      "authors": "www.nature.com",
      "host": "www.nature.com",
      "snippet": "All FN-diagnosed patients were examined clinically and investigated with appropriate laboratory tests, including complete blood picture, kidney function test, liver function test, serum electrolytes, chest X-ray, serum procalcitonin (if indicated), cultures, and sensitivity profiles from blood (coll",
      "score": 0.41734326
    },
    {
      "number": 13,
      "title": "Emergency management of fever and neutropenia in children with cancer: A review - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0735675721007920",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Emergency management of fever and neutropenia in children with cancer: A review - ScienceDirect\n# Emergency management of fever and neutropenia in children with cancer: A review. Care of pediatric cancer patients is increasingly being provided by physicians in community settings, including ge",
      "score": 0.8201387
    },
    {
      "number": 14,
      "title": "Approach to evaluation of fever in ambulatory cancer patients receiving chemotherapy: A systematic review - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0305737216301141",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Approach to evaluation of fever in ambulatory cancer patients receiving chemotherapy: A systematic review - ScienceDirect\n# General and Supportive Care Approach to evaluation of fever in ambulatory cancer patients receiving chemotherapy: A systematic review. Fever is common in cancer patients",
      "score": 0.78963995
    },
    {
      "number": 15,
      "title": "Oncologic Emergencies: The Fever With Too Few Neutrophils - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0736467919306614",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Oncologic Emergencies: The Fever With Too Few Neutrophils - ScienceDirect\nPatients who have received chemotherapy within 6 weeks of presentation are at high risk for neutropenia. While most patients with neutropenic fever do not have an identifiable bacterial source of fever, clinicians shoul",
      "score": 0.767429
    },
    {
      "number": 16,
      "title": "Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: A systematic review - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1040842813002618",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "# Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: A systematic review. Chemotherapy regimens have been classified as having a high, intermediate, or low risk of developing FN based on prospective clinical trials of selected patients with variable capture of tr",
      "score": 0.7272211
    },
    {
      "number": 17,
      "title": "Empirical Treatthent of Febrile Neutropenia",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/cid/article-pdf/24/Supplement_2/S256/1237018/24-Supplement_2-S256.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by JW Hathorn · 1997 · Cited by 90 — Administration of empirical antibiotic therapy is now standard practice in the management of febrile neutropenia,",
      "score": 0.61112726
    },
    {
      "number": 18,
      "title": "2014 Update by the Infectious Diseases Society of America",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/cid/article/59/2/e10/2895845",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by DL Stevens · 2014 · Cited by 4491 — A double-blind comparison of empirical oral and intravenous antibiotic therapy for low-risk febrile patients with neutropenia during cancer chemotherapy",
      "score": 0.55998856
    },
    {
      "number": 19,
      "title": "Clinical Practice Guideline for the Use of Antimicrobial Agents ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/cid/article/52/4/e56/382256",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by AG Freifeld · 2011 · Cited by 4910 — Panel recommends that every patient with fever and neutropenia receive empirical antibiotic therapy urgently (ie, within 2 h) after presentation,",
      "score": 0.51866865
    },
    {
      "number": 20,
      "title": "2016 Update by the Infectious Diseases Society of America",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/cid/article/62/4/e1/2462830",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "by PG Pappas · 2016 · Cited by 6102 — Additional insights can be gleaned from data derived from studies of empiric antifungal therapy involving febrile patients with neutropenia who had candidemia",
      "score": 0.5157425
    },
    {
      "number": 21,
      "title": "Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9394251",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "##  can affect both adults and children, the latter has a higher chance of infections with an unknown origin. Prompt empiric broad-spectrum antibiotic administration is collectively considered the best therapeutic approach. This review aims to analyze the latest works from the literature regarding t",
      "score": 0.78846955
    },
    {
      "number": 22,
      "title": "ESMO Clinical Practice Guideline: Febrile Neutropaenia",
      "detail": "www.esmo.org",
      "url": "https://www.esmo.org/guidelines/esmo-clinical-practice-guideline-febrile-neutropaenia",
      "authors": "www.esmo.org",
      "host": "www.esmo.org",
      "snippet": "Febrile neutropaenia is the development of fever, febrile neutropaenia is associated with the intensity of chemotherapy and remains one of the most frequent",
      "score": 0.7451949
    },
    {
      "number": 23,
      "title": "Clinical prediction models for febrile neutropenia and its outcomes: a systematic review - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12137469",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "## Introduction\n\nFebrile neutropenia (FN) is a common and often life-threatening condition in cancer patients undergoing chemotherapy treatment. FN affects up to 20% of patients and has a mortality rate of 9.5% . This mortality increases to 50% in those with comorbidities or septic shock . FN is def",
      "score": 0.6636041
    },
    {
      "number": 24,
      "title": "Update on Febrile Neutropenia in Pediatric Oncological ... - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8700030",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "by F Cennamo · 2021 · Cited by 70 — Febrile neutropenia (FN) is a common complication of chemotherapy in oncological children and one of the most important causes of morbidity",
      "score": 0.6455898
    }
  ],
  "publishedAt": "2026-08-24T17:31:18.523169+00:00",
  "updatedAt": "2026-08-24T17:31:18.523169+00:00",
  "readingMinutes": 6,
  "slug": "febrile-neutropenia"
}