Fever +/- neutropenia is a medical emergency
Practice Guidelines for Fever +/- Neutropenia patients (PDF)
Fever and neutropenia
Fever: oral or temporal temperature ≥38.5°C or axillary temperature ≥ 38.0°C
Neutropenia: ANC <0.5 x 109/L
We recommend that the BC Children's Clinical Pathway be followed and the recommendations for empiric antibiotic use be implemented. (Caveat: individual hospital infection control policy may dictate other treatment based on their own antibiotic sensitivity profile).
The treating pediatric oncologist (after hours, the oncologist on call) should be notified when a child on active anticancer therapy develops a fever and neutropenia.
Please notify BC Children's Hospital
Oncology Clinic: 604-875-2345 ext 7079
After hours, weekends, and stat holidays:
Oncologist on call: 604-875-2161
Fever, non-neutropenic patients:
All children with central lines require blood cultures with new febrile episodes. If the patient is clinically well, caregivers are reliable, and there are no focal infections requiring treatment, empiric antibiotic therapy is not required.