Clinical haematology · UKMLA & AKT

Neutropenia and neutropenic sepsis

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise neutropenia and neutropenic sepsis — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Neutropenia = ANC <1.5 x10⁹/L; severe neutropenia = ANC <0.5 x10⁹/L (infection risk rises dramatically); agranulocytosis = ANC <0.1 x10⁹/L
  • Neutropenic sepsis = oncological emergency - mortality rises significantly with each hour of antibiotic delay
  • Most common cause: cytotoxic chemotherapy - bone marrow suppression + mucositis (gut barrier breakdown) → bacterial translocation → bacteraemia
  • Nadir typically 7-14 days after chemotherapy administration

Carbimazole and clozapine are the classic non-chemotherapy drugs causing agranulocytosis. Any patient on these presenting with fever or sore throat requires urgent FBC.

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