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Persistent Febrile Neutropenia — SCE Infectious Diseases MCQ

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HardImmunocompromised HostPersistent Febrile NeutropeniaSCE Infectious Diseases

A haemodynamically stable patient with high-risk febrile neutropenia remains febrile 48 hours after piperacillin–tazobactam. Cultures are negative and there is no new clinical focus. What is the best next step?

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Correct answer: B — Continue current therapy and reassess for occult infection

Persistent fever alone at 48 hours in a stable patient is not an indication to broaden antibacterials automatically. Continue appropriate empirical therapy, repeat examination and cultures, and investigate new focal signs. In prolonged high-risk neutropenia, persistent fever around 4–7 days despite antibacterials prompts an invasive-fungal strategy according to prophylaxis, imaging, biomarkers and local haematology guidance.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections