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Neutropenic sepsis — SCE Acute Medicine MCQ

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EasyHaematological EmergenciesNeutropenic sepsisSCE Acute Medicine

A 43-year-old woman is assessed on the acute medical unit. She is receiving chemotherapy and presents with fever 38.5°C and rigors. Neutrophil count is 0.1 x10^9/L. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: A — Give broad-spectrum intravenous antibiotics within one hour

Give broad-spectrum intravenous antibiotics within one hour is the best answer because neutropenic sepsis requires immediate empirical intravenous antibiotics. Start therapeutic anticoagulation while awaiting imaging is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Do not wait for neutrophil count confirmation if the patient is clearly high risk.

Reference: NICE CG151