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Questions and answers

Can I wait if I have a fever

Short answer: no. During treatment, especially when neutrophils are low, a fever is an emergency.

Last updated: ~1 min read
Night: a thermometer and a phone
Figure 1.Night: a thermometer and a phone

01Short answer

When immunity is weakened after chemotherapy, a fever is often the only sign of infection. Such an infection can become serious within hours and even turn into sepsis. So when you reach the threshold your team gave you (often around 38 °C), call or go to the place they named without waiting. In hospital, blood tests and cultures are taken and antibiotics are started quickly. Early treatment saves lives.

02Simple explanation

In neutropenia a fever is an alarm signal.

Even a few hours’ delay can matter.

03Scientific explanation

For febrile neutropenia, international guidelines (for example ESMO and IDSA) advise starting antibiotics as soon as possible after arrival, ideally within an hour.

Chills, low blood pressure, fast breathing and confusion can be signs of severe infection or sepsis.

04What happens in the body?

What to do

Take your temperature, note the time and call your team’s emergency number. They will tell you where to go. Call even at night.

What happens in hospital

An examination, blood tests, blood cultures and, if needed, urine tests and a chest X-ray. Antibiotics are often started without waiting for results.

The open hospital door
Figure 2.The open hospital door

Be prepared

Keep a thermometer, a list of emergency numbers and a packed bag at home. Carry a summary of your treatment.

Antibiotics start quickly
Figure 3.Antibiotics start quickly

05Steps when you have a fever

Four steps, no waiting.

Measure — Note the temperature and time.1MeasureNote the temperature and time.
Call — Your team’s emergency number.2CallYour team’s emergency number.
Go — To the named place at once.3GoTo the named place at once.
Fast treatment — Antibiotics start quickly.4Fast treatmentAntibiotics start quickly.
SafetyEarly treatment prevents complications.
A calm planA ready plan reduces panic.

06Key points at a glance

TopicIn brief
What to doTake your temperature, note the time and call your team’s emergency number. They will tell you where to go. Call even at night.
What happens in hospitalAn examination, blood tests, blood cultures and, if needed, urine tests and a chest X-ray. Antibiotics are often started without waiting for results.
Be preparedKeep a thermometer, a list of emergency numbers and a packed bag at home. Carry a summary of your treatment.

07Key terms

Febrile neutropenia
A fever with low neutrophils.
Culture
A test that looks for germs in the blood.
Empirical antibiotic
An antibiotic started before the germ is known.

08Key points

  • A fever during treatment is an emergency.
  • Do not wait; call.
  • Antibiotics start quickly.
  • Keep a thermometer and numbers ready.

09Frequently asked questions

Should I call even for a mild fever?

Yes, if it reaches the threshold your team gave you.

Can there be infection without fever?

Yes; chills, weakness or breathlessness are reasons to call too.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Should I call even for a mild fever?

  2. Can there be infection without fever?

My questions

12Sources

  1. National Cancer Institute (NCI). Infection and Neutropenia during Cancer Treatment
  2. NHS. High temperature (fever) in adults
  3. NHS. Sepsis
  4. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: absolute neutrophil count
  5. National Cancer Institute (NCI). Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  6. NHS (UK). Acute myeloid leukaemia
  7. National Cancer Institute (NCI). Common Cancer Myths and Misconceptions
  8. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: graft-versus-host disease
  9. American Cancer Society. Neutropenia (Low White Blood Cell Counts)
  10. American Cancer Society. Typical Treatment of Acute Myeloid Leukemia (Except APL)
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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