ABSTRACT
Bodey et al,1 by noting the relationship between absolute neutrophil counts (ANC) less than 1000/mm3 and an increased risk of infection, especially serious infection, identified fever and neutropenia as a high-risk clinical state. Although assessing patient risk is an integral aspect of a physician’s role, formal discussions of risk assessment are rare in medical textbooks. However, risk assessment has been central to the management of cancer patients with fever and neutropenia since its original description by Bodey and colleagues. Since that report, many papers have identified factors that either clinically or statistically are associated with outcomes in patients with fever and neutropenia. In this chapter, we will provide an overview of the initial clinical approach to the neutropenic cancer patient who presents with fever, provide a framework for risk assessment as it relates to the care of patients with fever and neutropenia, and detail some of the characteristics that define low-and high-risk subgroups that can be used to help the clinician make initial decisions regarding site of care (inpatient versus outpatient) and route for antibiotic therapy (oral versus intravenous).
