Neutropenic sepsis

[theclick]

A close family member is in hospital with this, developed as a complication of lung cancer. I'd really like to understand it more for my family. He had chemo and white blood cells are low so caught the infection. He is on antibiotics but one type didn't work so he is now on another. Has anyone else experienced this?

Hi, I'm oncology research nurse so understand how anxious it can be
Following chemo, patient's neutrophils, white blood count and haemoglobin ( in fact all blood counts)can be at their lowest 5-7 days after each cycle of chemo.
It's important for them to keep an eye on their temperature and general health at this stage as their immune system is severely compromised and even a simple cold virus can be life threatening. we usually advise patients to know what is a 'normal ' temp for them , but that if it goes above 37.5 degrees they must contact the day unit/ ward immediately so they come in to have blood cultures taken and started on antibiotics
Will start on a general cocktail of drugs according to the hospitals neutropenia sepsis policy and will have their temp/ BP/ pulse / urine output measured frequently initially. may need to change antibiotics one definitive blood culture results are back .Start with Intravenous antibiotics initially and once improving oral tablets and once blood counts start to improve they can go home
Next cycle of chemotherapy may need to be delayed until blood counts are satisfactory and dose age of chemotherapy may also need to be reduced, especially if patient more elderly/frail
Hope this is useful....your relative hopefully will have been given an info pack when they started chemo explaining what to do regarding feeling unwell, but don't hesitate to phone chemo unit for advice....we get phone calls all the time and have checklist to advise when a patient needs to come in

This is incredibly useful.

Unfortunately I don't think my relative knew any of this!

Their temp is currently 37.2 but having called hospital today it seems to have gone up slightly. He is over 70 and looking frail so we are very worried. Just hard to see him in this state. Is it normal that one course of antibiotics wouldn't work?

It is possible he may need another antibiotic....if he's elderly and frail they will want to keep him in and make sure his blood counts recover
Chemotherapy can be very toxic especially in this age group and they have other underlying health problems ( one of the reasons some elderly people do not get chemo as it can sometimes do more harm to their quality of life)
He should have a lung cancer specialist nurse you could speak to ( with his consent)
Sorry you're going through this at the moment

Thank you, and thank you for your wishes

I know you can't answer this, but there is a chance he will recover? We want to bring him home so he can be around family and not in a depressing hospital room. That means he can have home comforts and not spend his final time in there.

There's every chance he will recover especially if his blood counts recover with the right antibiotics.. You may need to have some soul searching talks with his Drs to see if they think he will be well enough for more chemo or to concentrate on quality of life rather than quantity
If this is the case and he's not going to have any more chemo you should be put in touch with the palliative care team who will be available to talk about what care packages are around in your area and make sure these are in place for when he goes home....( can vary depending on what part of country you live in )he may need hospital bed/ commode/ chair etc which the hospital Occupational therapists can arrange to make your lives a bit easier
The Macmillan website is a very useful website( lung cancer forum)...there are forums there with people to talk to who are going through what your experiencing
www.macmillan.org.uk/information-and-support/lung-cancer
This may be helpful

www.macmillan.org.uk/cancerinformation/ifsomeoneelsehascancer/advancedcancer/caringforsomeone.aspx
Here's another link to page which may help and you can phone them for advice as well x