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Low neutrophils: hygiene as a shield

Neutrophils are the first defence against bacteria and fungi. When they are low (neutropenia), even an ordinary germ can cause a serious infection, and a fever may be the only sign.

Last updated: ~1 min read
Hand sanitiser being poured into an open palm
Figure 1.When neutrophils are low, hygiene is a shield

01Short answer

Wash your hands often: before eating, after the toilet and when you come in from outside. Shower or bathe daily and care for your mouth daily. Ask family and visitors to wash their hands too, and ask anyone who is ill to stay away. Avoid crowds, sick people, animal waste, soil and rotting leaves. Follow the food safety rules (“Handwashing: the simplest protection” and “Eggs and dairy: safe choices”). No rectal thermometers, suppositories or enemas. Take your temperature as your team advises; for 38 °C or higher, or chills, call at once and do not take medicines on your own.

02Simple explanation

Hands come first.

Crowds: no.

Check your temperature.

38 °C: call.

03Scientific explanation

NCI: during neutropenia, hand hygiene, avoiding sick people and acting quickly on a fever lower the risk of infection.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Febrile neutropenia

A fever with neutropenia is an emergency.

Hidden infection

With few neutrophils, signs of inflammation can be faint.

Neutrophils
Figure 3.Neutrophils — Low neutrophils: hygiene as a shield

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
Febrile neutropeniaA fever with neutropenia is an emergency.
Hidden infectionWith few neutrophils, signs of inflammation can be faint.
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Neutrophil
A white blood cell that fights bacteria.
Febrile neutropenia
A fever with a low neutrophil count.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • Wash.
  • Check.
  • Call.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

Should I wear a mask?

Sometimes teams advise it; ask your own team.

Should I take a fever reducer?

Not unless your team says so; it can hide a fever.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

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 wear a mask?

  2. Should I take a fever reducer?

  3. What should I watch every day?

My questions

12Sources

  1. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  2. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  3. National Cancer Institute. Anemia and Cancer Treatment
  4. World Health Organization. World Hand Hygiene Day
  5. American Cancer Society. Therapy, Counseling, and Support Resources for People with Cancer
  6. NCCN Guidelines for Patients. Distress During Cancer Care
  7. Cancer Research UK. Mental health and cancer
  8. Lancet Oncology, 2011. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies
  9. Journal of the National Comprehensive Cancer Network, 2019. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology
  10. National Cancer Institute (NCI). Meditation and Relaxation for Your Mind and Body
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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