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학습 자료 둘러보기 →A single temperature of 38.3°C (101°F) or higher in a patient with an absolute neutrophil count (ANC) <500/μL constitutes a medical emergency. The presence of rigors strongly suggests a high bacterial load and impending hemodynamic instability.
Immediate priorities include obtaining blood cultures (peripheral and from any central line) and administering empiric broad-spectrum antibiotics within 60 minutes of fever documentation. Do not delay antibiotics for culture collection if it is logistically difficult.
In the pre-engraftment phase, the absence of neutrophils means the patient may lack typical signs of localized infection (pus, erythema). A fever with rigors is often the only early sign of a life-threatening bloodstream infection with organisms like gram-negative rods, which can carry a mortality rate exceeding 70% if treatment is delayed.
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