Suggest treatment for fever and low white blood count after chemotherapy

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Posted on Wed, 10 Jun 2015 in Cancer
Question: Fever and low white blood count on chemo after 3 rounds of oxyplatin and raltitrexed .

Dr cannot find cause of infection so can this be treated as sepsis ?
doctor
Answered by Dr. Monish De 38 minutes later
Brief Answer:
blood culture test

Detailed Answer:
Hi

Since you are having fever and low white blood count after 3 rounds of chemotherapy you may be suffering from febrile neutropenia which is a kind of infection of your blood

As the cause of infection cannot be found it can be treated as sepsis and i would advise you to do a blood culture test and the condition needs to be treated by sensitive antibiotics

Regards

DR DE
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Monish De 2 hours later
Is this bad infection ?
doctor
Answered by Dr. Monish De 3 minutes later
Brief Answer:
It is very dangerous infection

Detailed Answer:
Hi

Yes the infection can be very dangerous

If not treated within 3 days it may even cause death

With sensitive antibiotics it has to be treated with granulocyte stimuating factor injections for 3 days to bring the wbc count to normal level

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Monish De 51 minutes later
Is this a chemo side effect then ? He's on antibiotic but they are not sure what it is exact .

His stoma are feels tender and painful too so can infection b there
doctor
Answered by Dr. Monish De 10 minutes later
Brief Answer:
Side effect of chemotherapy

Detailed Answer:
Hi

Yes it is a side effect of chemotherapy

Blood cuture must be done immediately to know the exact type of bacteria that has grown in blood and its sensitivity to antibiotics

His stoma is tender due to inefction

Regards

Dr De
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Monish De 47 minutes later
Yes thy have done cultures yesterday .

Cant
This b treated with antibiotics ?
doctor
Answered by Dr. Monish De 5 minutes later
Brief Answer:
Can be treated by sensitive antibiotic

Detailed Answer:
Hi

Yes it can be treated by sensitive antibiotic

The blood cuture will tell us which antibiotic will work against the bacteria in the blood

Culture report generally takes 3 days of time to come

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Monish De 16 hours later
The fever has come down today but the bp in in the 83-88 range ?
doctor
Answered by Dr. Monish De 3 hours later
Brief Answer:
Still infection is present

Detailed Answer:
Hi

Though the fever has come down as the blood pressure is low there is still infection present in the blood

I would advise IV fuids Normal Saline 500 ml to be given every 8 hrs

The present antibiotic should be continued till the blood culture report comes

A complete blood count test with differential count should be repeated after 4 days

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De 36 minutes later
Yes they are giving that . The bp sometimes goes up to 110 etc and sometimes down to 88 few occasions only

Plus I'm shocked as heamoglobin is 6.9. Yesterday was 8.9 and before chemo was 10.2
doctor
Answered by Dr. Monish De 46 minutes later
Brief Answer:
2 units of packed red blood cell transfusion

Detailed Answer:
Hi

Yes as the infection goes away the bp wil come back to normal

As haemoglobin is 6.9 i would advise 2 units of packed red blood cell transfusion

Regards

Dr De
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Monish De

Oncologist

Practicing since :2004

Answered : 2233 Questions

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