46 year old woman with breast cancer presents to the Emergency Department after being advised to attend by the chemotherapy unit.

She states she has been feeling unwell for the last 24 hours with a cough and fever. She has had FEC (Fluorouracil (5FU), epirubicin and cyclophosphamide) chemotherapy 12 days before.

On Examination

On examination she looked unwell. There was no obvious focus of infection during examination.

  • Temperature – 40.2

  • HR – 105

  • BP – 105/60

  • RR – 20

  • Sats – 96% OA

Questions

Answer one question before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. The first part of teaching will be spent discussing this case:

  1. Please define neutropenic sepsis

  2. What key history factors need to be identified?

  3. Please describe your detailed physical examination?

  4. Why must a DRE not be performed?

  5. How would you investigate this patient?

  6. How would you manage neutropenic sepsis and what is your antibiotic regime?

  7. What is the MASCC score used for, and what is it calculated from?

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