What initial investigations should I perform for a patient presenting with neutropenia?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For a patient presenting with neutropenia, the initial investigations should include a full blood count to confirm neutropenia and assess other cell lines, kidney and liver function tests (including albumin), C-reactive protein, lactate, and blood cultures to identify any infection. Additional peripheral blood cultures should be taken if the patient has a central venous access device and it is clinically feasible. Urinalysis is recommended in children under 5 years. A chest X-ray should not be performed routinely unless clinically indicated. These investigations help assess the severity, identify possible infection sources, and guide management decisions.

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What initial investigations should I perform for a patient presenting