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Infection and Chemotherapy—Diagnosis and Prevention
Low White Blood Count and Febrile Neutropenia— Diagnosing Infection
Fever (temperature higher than 100°F or 38°C) is often the first sign of infection. If you develop fever and know you have a low white blood cell count, you may have a condition called febrile neutropenia. A low white blood cell count can place you at risk for infection. During chemotherapy, infection can be life-threatening.1 You should contact your doctor immediately or go to the nearest emergency room.
While on chemotherapy, you should take your temperature every day or as recommended by your healthcare professional—and record it in your journal which is one of your Tools for Organizing Your Cancer Information.2-5
An infection can occur in any number of places throughout the body. Specific symptoms can indicate the site of your infection and help target your treatment.
| Location |
Symptoms |
| Bladder |
Painful urination |
| Gastrointestinal tract |
Diarrhea, cramping |
| Rectum |
Rectal bleeding, pain while defecating |
| Respiratory system |
Cough, congestion, yellow or green sputum (fluid coughed up from lungs) |
| Sinus |
Sinus pain, congestion, headache |
| Skin |
Redness, pain, tenderness or swelling near a cut |
| Systemic (throughout body) |
Flu-like symptoms (body aches and pains, chills) |
Infections may be serious and can delay your treatment. Be proactive and speak with your healthcare professional about how to reduce your risk of infection during chemo.
Low White Blood Count—Selected Steps to Help Avoid Being Exposed to Infection
It's important to take steps to help avoid infection. Take these simple but effective steps to help protect against infection (this is not a complete list):4
- Washing your hands thoroughly is the most important thing you can do to avoid infection.
- Avoid people with colds or the flu. Avoid large crowds to reduce your likelihood of coming into contact with someone who is sick.
- Bathe daily and carefully dry your skin.
- Use an electric razor instead of a blade to avoid cuts.
- Use lotion to prevent cracks in your skin.
- Wear gloves when gardening and wash up afterward.
- Clean cuts and scrapes right away with warm water and soap. Then, cover the area with a clean bandage.
- Cook your food thoroughly to kill any potential germs that may be on raw food.
Be Proactive Against Infection and Chemo Treatment Interruptions
Cancer patients receiving chemotherapy may be at risk of a low white blood cell count, especially those who already have a low count or who have previously received chemotherapy or radiation treatment. Patients who are older or patients with other conditions who have a low white blood count may be at risk of more severe infection and longer hospitalizations.6
More half the time fever and a low white blood cell count develops during the first cycle of chemotherapy.7 This puts patients at risk of developing an infection that could result in a hospital stay or a delay or reduction of your chemotherapy dose in the next cycle.3,8
Patients should discuss the possibility of infection and other possible side effects with their healthcare professional at the start of chemotherapy. Your doctor can help you develop a treatment plan that may help reduce your risk of infection.
1. What are the possible side effects of chemotherapy? American Cancer Society website. Updated June 17, 2009. http://www.cancer.org/docroot/ETO/content/ETO_1_4X_What_Are_The
_Side_Effects_of_Chemotherapy.asp?sitearea=ETO. Accessed June 4, 2010.
2. Medline Plus medical encyclopedia—urinary tract infection. National Institutes of Health website. http://www.nlm.nih.gov/medlineplus/ency/article/000521.htm. Accessed June 4, 2010.
3. Chemotherapy and you. National Cancer Institute. Update May 2007. NIH Publication No. 07—7156. http://www.cancer.gov/cancertopics/chemotherapy—and—you.pdf. Accessed June 4, 2010.
4. Infections in people with cancer. American Cancer Society website. Updated September 8, 2008. http://www.cancer.org/docroot/ETO/content/ETO_1_2X_Infections_in
_People_with_Cancer.asp. Accessed June 4, 2010.
5. Bacterial infections of female reproductive organs. Brigham and Women's Hospital website. http://healthlibrary.brighamandwomens.org/RelatedItems/2,124. Accessed July 30, 2009.
6. Kouroukis CT, Chia S, Verma S, et al. Canadian supportive care recommendations for the management of neutropenia in patients with cancer. Curr Oncol. 2008;15:9—23.
7. Crawford J, Dale DC, Kuderer NM, et al. Risk and timing of neutropenic events in adult cancer patients receiving chemotherapy: the results of a prospective nationwide study of oncology practice. J Natl Compr Canc Netw. 2008;6:109—118.
8. Dale DC. Drugs. 2002;62(Suppl 1):1—15.
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