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Neutropenic Sepsis Symptoms

Neutropenic Sepsis Symptoms

Neutropenic sepsis is a potentially fatal condition. It must be diagnosed and treated quickly to prevent life-threatening complications occurring.

If a patient becomes critically unwell or dies because medical practitioners did not recognise the symptoms of neutropenic sepsis, there could be a case of medical negligence.

For more information on claiming compensation for neutropenic sepsis, please get in touch with our legal team today. We specialise in medical negligence claims and offer free, no obligation advice.

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Neutropenia

Neutropenia is when the number of neutrophils in the blood falls to an abnormally low level. Neutrophils are a type of white blood cell. They are produced by the bone marrow and help the body fight infection.

Neutropenia and chemotherapy

Neutropenia is commonly associated with anti-cancer therapy, most notably chemotherapy. Neutropenia can be caused by radiotherapy, but it is rare.

Chemotherapy temporarily suppress the bone marrow's ability to function normally. This lowers the number of neutrophils in the blood. If an infection does arise, the body will not be able to respond.

Neutropenia caused by chemotherapy is short-term. Normally a patient will become neutropenic after having a cycle of chemotherapy, although it may take seven to 14 days for neutrophil levels to reach their lowest point. Throughout this time, a patient will be vulnerable to infection.

The number of neutrophils will then gradually improve until they are back to normal, or nearly-normal, levels.

Other causes of neutropenia

Neutropenia can be caused by factors other than chemotherapy. Potential causes of neutropenia include:

  • Diseases that damage the bone marrow – leukaemia, aplastic anaemia
  • Parasitic diseases – malaria, Dengue fever, Lyme disease
  • Infection – HIV, TB, hepatitis
  • Chronic conditions – Crohn's disease, over-active thyroid
  • Congenital conditions – myelokathexis
  • Autoimmune diseases – lupus, rheumatoid arthritis
  • Medication – epilepsy drugs, blood pressure drugs
  • Vitamin deficiency – Vitamin B12, folate

This is not an exhaustive list of neutropenia causes. Lots of illnesses, conditions and medications can result in neutropenia, although not all patients will be affected in the same way.

Neutropenic sepsis

As mentioned above, neutrophils help to fight infection. Therefore without the normal number of neutrophils, the immune system will not be able to respond to an infection as effectively. If someone with neutropenic does contract an infection, the body will not be able to fight it off and the patient will fall ill.

Nevertheless, the body will still attempt to confront the infection, and will react in the usual way of opening the blood vessels. This allows a clotting agent to leak out into the fatty tissue, where it would ordinarily assist in the infection-fighting process.

The problem with neutropenia is that the immune system will not have the resources to keep the infection in one place – called a localised infection. The infection will subsequently spread. In response, blood vessels across the body will leak.

When the body responds to an infection in this way, the patient is said to have sepsis. When sepsis occurs as a result of neutropenic, it is called neutropenic sepsis.

Neutropenic sepsis symptoms

Sepsis is very dangerous, because when the blood vessels leak in this way, it causes a drop in blood pressure. The heart will not be able to pump blood around the body, and within a short space of time all of the organs will be deficient in oxygen (which is carried in the blood). Multi-system organ failure will follow.

The entire septic response will happen very quickly. From the point of developing sepsis, it can be just hours before the patient deteriorates to septic shock with organ failure. The symptoms of neutropenic sepsis therefore progress rapidly as the patient becomes increasingly unwell.

Symptoms of neutropenic sepsis

The symptoms of neutropenic sepsis are the same as sepsis not caused by neutropenia.

Symptoms will begin when an infection takes hold. The initial symptoms of neutropenic sepsis are:

  • General feeling of being unwell
  • High temperature

The patient will become increasingly poorly as the infection spreads and the body suffers a septic inflammatory response. At this stage, symptoms include:

  • Fever
  • Rigors (uncontrollable chills and shivering)
  • Muscle pain
  • Shallow, laboured breathing
  • Sickness and diarrhoea
  • Rapid heartbeat

Next, the circulation will begin to fail and organs will begin to lose function. Most notably the kidneys will not function properly, leading to decreased urine output. The symptoms of severe sepsis are:

  • Pale or mottled, clammy skin
  • Feeling faint/collapse
  • Slurred speech
  • Decreased urine output

Finally, there will be a significant drop in blood pressure. This is called septic shock. The symptoms at this stage include:

  • Low blood pressure which causes dizziness and collapse
  • Mental confusion and disorientation
  • Loss of consciousness

A patient with septic shock will be critically unwell and will require organ support in the Intensive Care Unit.

Recognising neutropenic sepsis symptoms

To stop a patient becoming critically unwell from neutropenic sepsis, the signs and symptoms must be recognised in the early stages of the condition.

Measures to prevent neutropenic sepsis can be implemented if there is a known risk. For example, chemotherapy patients may be given antibiotics alongside their anti-cancer therapy.

However, this may not always be possible, and even if antibiotics are given, an infection may still arise. Thus early detection is the best strategy for the management of neutropenic sepsis.

Medical practitioners should be able to spot the early symptoms of sepsis. If a patient is known to be neutropenic, or is at risk of neutropenia, doctors should be especially quick to suspect sepsis.

There is no definite test that says whether or not a patient has sepsis. A diagnosis is based upon the patient's symptoms and their clinical presentation. This means that understanding a patient's symptoms and acting upon them is key.

Failure to spot neutropenic sepsis symptoms

Unfortunately neutropenic sepsis is not always spotted in time and a patient falls seriously unwell. For a patient with an already compromised immune system, it may be difficult to recover from the condition, resulting in long-term complications. Some patients will not survive the illness.

If you or your loved one has suffered harm because medical practitioners failed to act upon the symptoms of neutropenic sepsis, there could be grounds for legal action. Contact us to find out more.

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