Neutropenic Fever (Oncologic Emergencies)

The definition, clinical presentation, pathogenesis, treatment, and prognosis of neutropenic fever.

#oncology #hematology

[eyal]

Dr. Strong, You are amazing, I used to be worried you would sell out one day! I hope you never feel that you have to! I get happy every time I see you are still contributing to the world "just because". Your name will be remembered in history as one of the greatest educators! You are my role model!

[monikarajpal]

To the point lectures- really gain a lot of clinical knowledge from these lectures and experiences
Would love if you could update the antibiotic lectures from 9-10 years ago. Recently, also viewing the ID podcasts from Mofett. AGAIN THANK YOU!

[waelfadlallah]

Such an intresting topic to talk about. It's also perfectly organized. Thank you so much :)

[schan]

Still remember first being on call as a medical intern and I was being slammed with quite a few neutopenic fevers. Wish I had this!!!

[nicolasvethencourt]

Hello Dr. Strong, here a big fan of your work. Please consider a serie on chronic kidney disease, that would be

[dr.odayfathy]

Thank you for the great information
My question is should we use anti pyretics or not as its my affect the follow-up

[zephaniahoyugi]

How about voriconazole, empiric antifungal cover

[deproissant]

Couple of questions
1) Is there any way to predict the duration of neutropenia with somewhat reliable accuracy?
2) Is there any particular bacteria we're concerned about in severe cases, so much so that we're empirically adding FQ or aminoglycosides? Aren't vancomycin and Zosyn broad enough?

[Kareemo]

Is removal of CVC indicated in bloodstream infection with CVC insertion in another location or complete removal until bacteraemia is resolved?

[eirikb]

Do you start empiric antibiotics before you receive the neutrophile count to see if the patient is actually neuotropenic, or should you start it right after cultures are drawn if the patient has fever?

[jeromeriedl]

Oof that solid tumor or no previous fungal infection for 4 points is an interesting and rough one. I’m guessing that’s because of fungal infections tendency to pop up later and the continuous nature of liquid tumor chemotherapy

[VyewVyew]

Hi Dr Strong, another great video as usual!

After doing my Haematology/Oncology job I now routinely ask patients about perianal pain/rectal pain due to being caught out by patients with prolonged neutropenic sepsis due to what seemed like a forgettable symptom, but on MRI demonstrated neutropenic proctitis and anal fistula. Are perianal and rectal sources of neutropenic infection something you’ve unexpectedly encounted as well?

Also, with regards to aminoglycosides it’s very common in the UK to use Gentamicin as the sepsis “panic button” for double coverage of gram -ve organisms. E.g “if deteriorates give STAT dose of 5mg/kg gent”

[KaldonisPondo]

Celcius? Can you state that in american please?