emDocs - May 13, 2019 - Author: Long B - Edited by: Koyfman A
"Key Points
- Fever with neutropenia is an emergency. Neutropenic fever is defined by the IDSA as oral temperature > 38.3o C or temperature >38.0oC for 1 hour with neutropenia.
- In patients who are risk stratified as low risk, outpatient therapy is safe when compared to inpatient therapy.
- Oncology consultation is recommended for patients with neutropenic fever, especially with the decision regarding discharge.
- While several risk scores can be used with oncology consultation, including the MASCC and CISNE scores, clinical judgment should overrule clinical scores.
- If the patient is appropriate for outpatient therapy following IV antibiotics and observation in the ED, an oral fluoroquinolone (ciprofloxacin or levofloxacin) plus amoxicillin/clavulanate is recommended."