Neutropenic sepsis is a body-wide reaction that can occur when a person with an infection or injury also has a low level of immune cells called neutrophils. Neutropenic sepsis is a medical emergency requiring immediate treatment.

Sepsis is an inflammatory impairment of the immune system in response to infection or traumatic injury.

Anyone can experience sepsis. It is a serious medical condition and a leading cause of hospital readmissions and deaths.

Neutropenia is a condition featuring low neutrophils — immune cells that kill microorganisms, such as fungi and bacteria, and restrict the replication of viral cells. People with neutropenia have weakened immunity and have more difficulty fighting infections.

Neutropenic sepsis is sepsis that occurs in someone with neutropenia.

This article will discuss neutropenic sepsis symptoms, causes, risk factors, diagnosis, treatment, complications, outlook, and prevention.

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Because of their higher risk for sepsis, it is important for people with neutropenia to contact a healthcare professional at the earliest sign of infection.

These may include:

Sepsis symptoms include:

Neutropenia has a range of possible causes.

Reasons a person might have low neutrophils include:

Causes of sepsis include:

  • bacterial infection
  • fungal infection
  • viral infection
  • non-infectious damage, such as traumatic injury

Sepsis is not the infection or the injury but the body’s reaction to it.

Typically, the immune system releases proteins and chemicals into the bloodstream in response to infection or injury.

In sepsis, the immune system response becomes exaggerated. This causes blood clots, excessive inflammation, and leaking blood vessels, all of which can impair blood flow and lead to organ damage or death.

A person with neutropenia can develop sepsis more easily than someone with typical neutrophil levels.

Risk factors for sepsis in people with neutropenia include:

  • severe neutropenia, with an absolute neutrophil count of under 500 per microliter
  • neutropenia lasting longer than 7 days
  • acute leukemia
  • prior surgery
  • prolonged hospital stay
  • delayed admission to the intensive care unit
  • advanced disease
  • the use of a Hickman catheter
  • chemotherapy
  • pretreatment with antibiotics or nonadapted antibiotic therapy
  • low blood phosphorus levels, which doctors call hypophosphatemia
  • low blood protein levels, which doctors call hypoproteinemia

When people have neutropenic sepsis, their risk factors for developing septic shock include:

  • pneumonia
  • rapid breathing, which doctors call tachypnea­
  • changes in certain proteins, clotting factors, and other biochemicals

There are several steps doctors follow in diagnosing sepsis:

  • assessing symptoms
  • blood tests to check for bacteria and to measure white cell count
  • urine tests to check for urinary tract infections
  • imaging, such as a CT scan or chest X-ray, to find an infection source
  • organ function analysis and monitoring

The goal of sepsis treatment is to stabilize blood pressure, protect vital organs, and stop infection.

The first step is often antibiotics and fluids. For some people, this is sufficient to get sepsis under control.

For others, more intervention is necessary, such as:

  • kidney dialysis
  • intubation, which involves using an artificial breathing tube
  • surgery to remove the infection

Experts need to do more research to develop a sepsis treatment directly targeting the immune system response.

Some people recover completely from sepsis.

Others live with lingering effects, such as organ damage. Sepsis may also alter a person’s immune system, leaving them more susceptible to future medical conditions.

People with neutropenic sepsis may have a higher risk of kidney injury than those with non-neutropenic sepsis.

According to research from 2016, the hospital survival rates for neutropenic sepsis were 50–60%, with an overall mortality rate of 54.9%.

Factors connected with more negative outcomes included:

The Centers for Disease Control and Prevention (CDC) recommends that people speak with healthcare professionals about preventing sepsis-causing infection.

They also suggest:

  • managing chronic conditions such as diabetes or cancer
  • staying up to date with recommended vaccinations
  • practicing effective handwashing
  • cleaning and covering cuts until they have healed
  • learning the signs of sepsis to know when to seek medical assistance
  • avoiding delays in seeking treatment

Anyone can develop sepsis, but people with neutropenia have a higher risk.

Sepsis occurs when a person’s immune system overreacts to infection or injury. The resulting inflammatory response can lead to organ damage and, in some instances, death.

The goal of sepsis treatment is to fight infection, stabilize blood pressure, and prevent organ damage. Doctors use fluids and antibiotics, and sometimes other treatments such as kidney dialysis, intubation, or surgery.

A person can reduce their likelihood of developing sepsis by practicing appropriate hygiene, staying current with their vaccinations, and managing any underlying conditions they live with.

It is important to know the symptoms of infection and sepsis, since the latter is a medical emergency requiring immediate medical treatment.