Key clinical signs and symptoms to identify neutropenic sepsis in a patient undergoing chemotherapy include:
- A neutrophil count of 0.5 × 10⁹ per litre or lower (severe neutropenia) in a patient receiving anticancer treatment such as chemotherapy.
- A temperature higher than 38°C (fever) or other signs or symptoms consistent with clinically significant sepsis.
- Signs of systemic infection or sepsis such as unwell appearance, hypotension, tachycardia, or other clinical features of sepsis.
- Additional symptoms may include malaise, chills, rigors, or other indicators of infection, although fever is the primary trigger for suspicion.
Patients undergoing chemotherapy who become unwell with these features should be suspected of having neutropenic sepsis and referred immediately for urgent assessment and treatment in secondary or tertiary care.
Initial clinical assessment should include history, examination, and blood tests including full blood count to confirm neutropenia, blood cultures, and markers of infection and organ function.
Because neutropenic sepsis is a medical emergency, early recognition based on fever and neutropenia in the context of chemotherapy is critical to prompt management.
Summary: The hallmark clinical signs are fever (>38°C) combined with neutropenia (neutrophil count ≤0.5 × 10⁹/L) in a patient receiving chemotherapy, along with symptoms/signs of systemic infection or sepsis.
References: NICE CG151,NICE CKS,NICE NG51