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Neutropenic sepsis — SCE Acute Medicine MCQ

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EasyCancer, palliative care and haematologyNeutropenic sepsisSCE Acute Medicine

A 45-year-old woman receiving chemotherapy for breast cancer presents with fever and rigors. Temperature is 38.5°C, pulse 126/min and BP 102/64 mmHg. Full blood count shows neutrophils 0.2 × 10^9/L and platelets 88 × 10^9/L. Chest radiograph is clear and urine dipstick is negative. What is the most appropriate next step in management?

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Correct answer: C — Give empiric intravenous antipseudomonal beta-lactam antibiotics immediately

This is neutropenic sepsis, which is a time-critical emergency even without an obvious source. NICE recommends immediate empiric IV antibiotic therapy with antipseudomonal cover after cultures where this does not delay treatment. G-CSF may be considered in selected cases but does not replace urgent antibiotics.

Reference: NICE CG151