Etiology:

Disinhibited NK cells

Actual infection

  • treat as indicated

ANC < 1500
Severe: <500

Fever over 101 or >100.4 for over an hour

Workup:
CBC
CMP
Bcx x 2
UA / Culture
CXR
LP if indicated

Chemo
Solid tumor:
Hematologic:

  • Induction therapy nadir 3 weeks
    Count recovery:
  • GCSF (filgrastim)

Viral

  • Acyclovir
    Fungal:
  • fluconazole
  • micafungin

Stop Criteria:

  • Afebrile 48hrs
  • If still neutropenic: prophylaxis
    • amox + cipro
    • moxi