Patient will present as → a 68-year-old woman presents to the emergency department due to fatigue, malaise, and a subjective fever. Her symptoms began approximately 1 week ago. Medical history is significant for small cell lung cancer recently treated with doxorubicin plus cyclophosphamide and etoposide. Her temperature is 102°F (38.9°C) and blood pressure is 100/80 mmHg. A complete blood count with differential is remarkable for an absolute neutrophil count of 320 cells/mm3. She is admitted to the hospital and administered intravenous cefepime.
Leukopenia is a decrease in the number of white blood cells (leukocytes) found in the blood, which places individuals at increased risk for infection
- Neutropenia, a subtype of leukopenia, refers to a decrease in the number of circulating neutrophil granulocytes, the most abundant white blood cells. The terms leukopenia and neutropenia may occasionally be used interchangeably
- Agranulocytosis is a complete absence of neutrophils - drugs that cause this include clozapine, propylthiouracil, penicillin G, methimazole, and dapsone
Low white cell count may be due to acute viral infections, such as a cold or influenza
- Associated with chemotherapy, radiation therapy, myelofibrosis, aplastic anemia, stem cell transplant, bone marrow transplant, HIV, AIDS, and steroid use
- Medical conditions such as systemic lupus erythematosus, Hodgkin's lymphoma, some types of cancer, etc.
- Medications such as clozapine, bupropion, minocycline, valproic acid, lamotrigine, metronidazole, immunosuppressive drugs, and interferons used to treat MS
Leukopenia can be identified with a complete blood count -normal WBC count 4.5– 11.0 K/ μL
- Complete metabolic panel
- Blood cultures
- Urine culture
- Culture of sites concerning for infection
- Radiologic studies and CT scan
Treatment will be guided by cause
- Discontinue causative agent, antibiotics in case of neutropenic fever