Neutropenic sepsis: preventing an avoidable tragedy

Abstract

Neutropenic sepsis is a life-threatening side-effect of chemotherapy—patients are still dying from this complication of treatment, and these deaths are largely preventable. The purpose of this article is to raise awareness of the condition, its severity and the importance of timely responses to it. The main issue for prehospital clinicians is that symptoms of neutropenic sepsis, especially in the early stages, are so vague that they are easily misinterpreted or dismissed as opposed to being indicative of a time-critical patient. The patient's history is of paramount importance in identifying patients in the community that are vulnerable to the condition—those recovering from chemotherapy. These patients are highly prone to infection and are temporarily immune compromized due to the medications that they have been prescribed. They are incapable of mounting a response to infection and infective agents can overwhelm them rapidly. It is imperative in this patient group to have a high degree of suspicion about ‘simple’ assessment findings and non-specific symptoms as these can progress very quickly to haemodynamic collapse and death. Timely hospital-directed antibiotic therapy and support can prevent this possible tragedy.