Preventing Infection in Patients With Neutropenia: Q&A With Dr Ruben A. Mesa

Individuals who develop neutropenia are at higher risk of infection, and they should understand the symptoms to look for that might mean they need to seek urgent medical care, explained Ruben A. Mesa, MD, of the Mayo Clinic.

Those individuals with neutropenia can also take preventive steps to reduce their risk of developing an infection that might result in hospitalization.

AJMC®: What are patients taught about neutropenia and when to go see a doctor?

RAM: So neutropenia refers to a decrease in a subset of white blood cells that we call neutrophils, and they are a subset that are very involved with fighting infections, in particular bacterial infections. When they’re below a certain threshold people are at great risk of infections. This might be from illness, this might be from a blood disease. This could be in relationship, most commonly, to a side effect of chemotherapy.

When the counts are low, individuals have a risk of infection. So if they develop fever, or start to feel ill, particularly if they’ve been warned that they have neutropenia, it’s important that they seek urgent medical care. Or at least communicate with their physicians to see if they should be put on antibiotics, or even hospitalized.

AJMC®: What can a patient expect once a neutropenia diagnosis has been made?

RAM: Neutropenia for patients really falls into 1 of 2 categories. One, a group of people that the neutropenia is short-lived, meaning that the blood counts go down but we expect that they will be coming back up again as they recover from a therapy. That’s probably the most common. The second are individuals where the neutrophils are chronically low from a blood illness. Their expectations are that it’s important that it be monitored and during that period of time when someone’s blood counts are low with neutropenia that the risk of infection is really monitored.

AJMC®: How can people with neutropenia reduce their risk of developing an infection?

RAM: So things that can help with this are: 1) if fever develops to seek urgent medical care; 2) when one is out in the general public doctors may recommend in crowded settings the use of a mask—this is probably more extreme cases.

What I suggest for folks is that most infections we pick up out in society are either form within our own body that we can’t control—from our mouth or our intestinal tract—or really from touching surfaces and then we touch our mouth or our eyes. So really alcohol based hand wipes or liquid gel, those things that really keep your hands clean are probably one of the most useful preventive things that people can do.