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definition of a fever
- single oral of 101
- greater than 100.4 for more than 1 hour
How to calculate ANC
ANC = WBC x % Neutrophils
%Neutrophils = %bands + % segs
At onset of signs and symptoms of infection, what should be done with afebrile patients?
started on empiric therapy
High risk of infection
- Prolonged neutropenia (>7 days)
- Uncontrolled malignancy
- Complex infection
- Significant comorbidities
If patient remain febril through the first 5-7 days, what should be initiated
antifungal drug with or without antibiotic change
48 hours after afebrile and ANC greater than 500
If ANC is less than 500 by 7, initial low risk, clinically well, antibiotics can be stopped when?
the patient is afebrial for 5-7 days
If ANC < 500 by day 7, initial high risk (<100, mucositis, unstable signs)
if persistent fever and ANC > 500
stop 4-5 days after ANC > 500
if persistent fever and ANC < 500
continue for 2 weeks
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