Febrile neutropenia: a well-looking emergency

Educational use only. Not clinically reviewed

61-year-old man for calm recognition, pathway activation, bounded empiric intent, reassessment, and handoff practice. About 7 simulated minutes.

What you will practise

Reconcile the fever, neutrophil count, chemotherapy day, and absent local signs.
Recognize an emergency despite a blind examination.
Activate the neutropenic sepsis pathway and culture ownership.
Review the timing and risk-score boundary.
Record bounded empiric intent, then reassess a strict later report.
Hand off continuing neutropenia, an absent source, and active risk.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

National Institute for Health and Care Excellence. Neutropenic sepsis: prevention and management in people with cancer. NICE clinical guideline CG151. Published 2012-09-19; surveillance 2019 and 2020 decided not to update. Key priority: treat as an acute medical emergency and offer empiric antibiotic therapy immediately.
Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52(4):e56-e93. doi:10.1093/cid/cir073. Still the standing comprehensive IDSA document.
Taplitz RA, Kennedy EB, Bow EJ, et al. Outpatient Management of Fever and Neutropenia in Adults: ASCO and IDSA Clinical Practice Guideline Update. J Clin Oncol. 2018;36(14):1443-1453. doi:10.1200/JCO.2017.77.6211. Scope limited to outpatient management of low-risk adults.

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.