Question

27yo male, with stage II Hodgkin’s lymphoma, presents to his oncologists’s office for 6-week follow-up s/p 4 cycles of ABVD chemotherapy.  He reports malaise and fatigue, but is otherwise in good spirits.  Vitals show:

• BP – 122/72 mmHg
• HR – 96 bpm
• RR – 15 bpm
• O2% – 100% on room air
• Temperature – 38.5^oC (101.4^oF)

Labs in the office are below:

Answer

This patient has a neutropenic fever.  This is an oncologic emergency because their immune systems has been completely destroyed by the chemotherapy and they are unable to mount an appropriate response to the infectious insult. In order to determine if a patient is neutropenic, you must calculate an Absolute Neutrophil Count (ANC).

MD Calc Link

Neutropenia =  ANC < 1500