Neutropenic Fever: A silent emergency for bone marrow disorder patients

We have all experienced the familiar symptoms of fever—chills, aches, and warmth—but few truly understand its purpose. Fever is not a disease, but a signal: the body's immune system is responding to infection, with the hypothalamus raising the body's temperature to make it less hospitable to invaders.

Fever can appear in various forms—intermittent, remittent, continuous, or relapsing—each indicating different underlying causes. Among them, neutropenic fever is particularly alarming, especially for patients with bone marrow disorders or those undergoing chemotherapy.

Neutropenic fever occurs when a person with neutropenia (a dangerously low count of neutrophils, a type of white blood cell) develops a fever. It is a medical emergency as the body's immune defences are severely compromised.

Neutropenia may result from chemotherapy (common in leukemia treatment), bone marrow disorders like aplastic anaemia or myelodysplastic syndromes, infections, or side effects of certain medications.

A minor infection in such patients can rapidly become life-threatening. Those undergoing intensive chemotherapy, such as CLAG-M regimens for acute myeloid leukaemia (AML), or bone marrow transplants, are at particularly high risk, especially of invasive fungal disease (IFD) and serious infections like pneumonia or cellulitis.

Call to Action: Precaution is crucial

• Immediate medical attention: Fever of 38.3°C once, or 38.0°C sustained for over an hour, requires urgent evaluation (IDSA/NCCN guidelines).

• Preventative medication: Prophylactic antibiotics or antifungals are often prescribed.

• Hygiene and isolation: Frequent handwashing and avoiding crowded or sick environments is vital.

• Regular monitoring: Blood tests help detect early signs of neutropenia.

• Dietary caution: Avoid raw or undercooked foods that could carry harmful bacteria.

• Family awareness: Educate caregivers and patients on warning signs and the need for swift medical response.

• Critical care readiness: In severe cases, neutropenic fever may lead to sepsis, requiring ICU admission and life support interventions.

Given the weakened immune state of blood cancer patients, infections can escalate quickly. Early detection, strict hygiene, and rapid treatment are essential.

Neutropenic fever is a silent emergency, and with proper awareness and timely care, we can better protect vulnerable individuals—especially those fighting blood cancers—from its deadly consequences.

The article is compiled by Jannatun Nayma.

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