What is Neutropenic Sepsis?
Neutropenic sepsis is when sepsis occurs due to a reduced number of white blood cells. It is a potential complication of anti-cancer therapy, most commonly chemotherapy.
Doctors should take steps to prevent neutropenic sepsis when appropriate. Immediate action should be taken if the condition develops or it could be fatal.
If there is a failure to adequately prevent or treat neutropenic sepsis and a patient is harmed as a result, legal advice should be sought. Please get in touch with our lawyers for more information.
What is neutropenic sepsis?
Neutropenic sepsis is when someone develops sepsis as a result of neutropenia.
Neutropenia is an abnormally low level of white blood cells, which are known medically as neutrophils. Sepsis is when the whole body becomes inflamed in response to an infection.
Thus neutropenic sepsis is when someone with a weakened immune system gets an infection and suffers a septic response.
How does neutropenic sepsis happen?
People with a normal level of white blood cells will be able to fight off infections when they arise. But when someone has neutropenia, they will have a diminished number of white blood cells and will therefore be particularly susceptible to infection.
When an infection does affect the body, a healthy immune system will send blood to the area. The blood contains white blood cells and other infection-fighting agents, all of which will help to kill the bacteria and contain the infection in one place. This is called a localised infection.
However, if the body has limited white blood cells, the immune system will be unable to ward off the infection. It will spread and the immune system will over-react, sending blood across the body. This will result in widespread inflammation and dangerously low blood pressure. When these side-effects occur due to an infection, a person is said to have sepsis.
Who is at risk of neutropenic sepsis?
Neutropenic sepsis is commonly associated with patients undergoing cancer treatment, usually chemotherapy. It can be caused by radiotherapy but it is rare.
Neutropenic sepsis is linked to anti-cancer therapy because the treatment can kill blood cells within the bone marrow, including neutrophils.
Other people at risk of neutropenic sepsis include:
- Elderly patients
- Patients with an indwelling central catheter
- Haematology patients
- Those with poor health
- Those with other conditions such as Chronic Obstructive Pulmonary Disease (COPD) and heart disease
Symptoms of neutropenic sepsis
The symptoms of neutropenic sepsis are the same as any other patient who develops sepsis. The symptoms of neutropenic sepsis include:
- A high temperature
- Chills and shivering
- Feeling unwell
- Nausea and diarrhoea
- Shallow breathing
- Fast heart beat
In the initial stages the patient may not seem too unwell. However, sepsis is a very fast-moving illness and the patient will deteriorate at an alarming speed. Further symptoms will develop which indicate the drop in blood pressure and lack of blood circulation. These include:
- Changes in skin colour, with mottled skin or a rash
- Mental confusion
- Reduced urine output
- Muscle pain
- Slurred speech
Diagnosing neutropenic sepsis
The first step towards diagnosing neutropenic sepsis is to recognise the signs and symptoms in the early stages.
Because neutropenic sepsis is associated with cancer therapy, a patient and their carer should be warned of the symptoms to look out for. The patient should also be told to seek immediate medical help if any of the signs develop. The most prevalent time for neutropenic sepsis to arise is seven to 10 days after chemotherapy treatment.
If a patient develops neutropenic sepsis outside of hospital, it is important to attend A&E at once. Alternatively a patient may already be in hospital, being treated for another condition.
Either way, doctors should ask a patient about the progression of symptoms and any risk factors present. If a patient has factors that increase their risk of neutropenic sepsis, such as cancer treatment or ill health, suspicions regarding sepsis should be especially raised.
Tests can then be ordered to confirm a diagnosis. Blood samples, and kidney and liver tests, are all helpful when diagnosing neutropenic sepsis.
Treating neutropenic sepsis
However, the results of these tests can take some time to return. While the analysis is underway, a patient should be started on antibiotics.
Administering antibiotics before a firm diagnosis has been obtained is called empiric antibiotic therapy. It is necessary with neutropenic sepsis due to the speed at which a patient's condition can become critical. Even a delay of just one hour in providing antibiotics can increase the likelihood of death.
Other treatment may be required depending upon the severity of a patient's condition. This can range from intravenous fluids to organ support within the Intensive Care Unit.
Preventing neutropenic sepsis
Due to the known risk of neutropenic sepsis during cancer treatment, medical practitioners may decide to offer a patient antibiotics as a preventative measure. This is known as administering prophylactic antibiotics. Ordinarily antibiotics will only be given during the expected period of neutropenia.
Death from neutropenic sepsis
Unfortunately neutropenic sepsis is potentially fatal. The National Institute of Health and Clinical Excellence (NICE) state that mortality rates for neutropenic sepsis in cancer patients ranges from 2% to 21%.
As mentioned above, doctors should try to prevent neutropenic sepsis in cancer patients by providing the appropriate antibiotic treatment.
Furthermore, any patient who develops sepsis should also be quickly diagnosed, whether or not they have cancer. This relies upon medical practitioners recognising the signs and symptoms of the illness.
Prevention and early detection are the best means of defence against neutropenic sepsis.
Neutropenic sepsis not diagnosed and treated
If medical practitioners fail to manage neutropenic sepsis adequately – either due to a failure to prevent the condition, or due to a failure to diagnose and treat the condition – there could be a case of medical negligence. This can be pursued by the patient or their family.
A solicitor who works in clinical negligence claims will be able to provide more information on claiming compensation for sepsis.
Talk to a legal expert about compensation for neutropenic sepsis
To find out whether you have a sepsis claim, please get in touch with us today.
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