Febrile neutropenia causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
Synonyms and keywords: F and N; fever and neutropenia; FN; hot and low; hot leuk; neutropenic fever; neutropenic fever syndrome; neutropenic sepsis
Overview
Bloodstream infections caused by endogenous flora and reactivation of latent infections account for a majority of initial febrile episode in neutropenic patients with cancer.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Febrile neutropenia is a life threatening condition and must be treated as such irrespective of the underlying cause.
Common Causes
- Acinetobacter spp
- Citrobacter spp
- Coagulase-negative staphylococci
- Enterobacter spp
- Enterococcus spp, including vancomycin-resistant strains
- Escherichia coli
- Klebsiella spp
- Pseudomonas aeruginosa
- Staphylococcus aureus, including methicillin-resistant strains
- Stenotrophomonas maltophilia
- Streptococcus pneumoniae
- Streptococcus pyogenes
- Viridans group streptococci
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | Cellulitis |
| Drug Side Effect | Chemotherapy |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | Acinetobacter, anaerobes, aspergillus, babesia, bacillus, candida, capnocytophaga canimorsus, cellulitis, citrobacter, clostridium difficile, coagulase-negative staphylococci, coccidioides spp, corynebacterium jeikeium, cryptococcus, cytomegalovirus, enterobacter, enterococcus, enteroviruses, Epstein-Barr virus, escherichia coli, hemophilus influenzae, herpes simplex virus, histoplasma capsulatum, human herpesvirus 6, influenza virus, klebsiella , legionella,
listeria monocytogenes, moraxella, mucorales, mycobacteria, neisseria meningitidis, nocardia, parainfluenza virus, plasmodium, pneumocystis jirovecii, pneumonia, proteus, pseudomonas aeruginosa, respiratory syncytial virus, serratia, staphylococcus aureus, stenotrophomonas maltophilia, stomatococcus, streptococcus pneumoniae, streptococcus pyogenes, strongyloides stercoralis, toxoplasma, varicella zoster virus, viridans group streptococci |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | Malignancy |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | Pneumonia |
| Renal/Electrolyte | No underlying causes |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |