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Neutropenic sepsis

In the current coronavirus (COVID-19) pandemic, people are still receiving and recovering from stem cell transplants.

Neutropenic sepsis remains one of the main risks during recovery. This can occur if your neutrophils are at a low level, leaving you potentially unable to fight off infection which may subsequently become septic.

If you need to attend your local hospital with a temperature, it is vital that the medical team considers neutropenic sepsis as well as COVID-19, to ensure you receive the most suitable treatment immediately.

We’ve developed an official Anthony Nolan letter to take with you to hospital, to highlight the risk from neutropenic sepsis and the action the medical team needs to take.

1) Simply follow this link to the Anthony Nolan letter 👉 https://bit.ly/3rEVFDm

2) In the two blank areas, add the name of your transplant centre keyworker contact and the name of your transplant centre.

3) Download, print or show this letter to the medical team when you arrive at your local hospital.

If you'd like to find out more about infections after transplant, see our Recovery: Body web section: https://www.anthonynolan.org/patients-and-families/recovery-body/dealing-infections

And if you have any concerns about any of this, please get in touch – our helpline is 0303 303 0303 and our email is: patientinfo@anthonynolan.org

All the best,

Tom

chelle_16

Comments

  • Hello Tom,

    I'm a new Community Online Champion and finding this post has been a blessing in disguise. I think this is an excellent resource for patients. When going through treatment I was likely to have Neutropenic sepsis every 3 or 4 weeks and had a passport for the local hospital but with being post SCT I always feared going in with possible Neutropenic sepsis without a supporting letter especially during COVID.

    Thank you for this.

    Michelle

  • Hi, I’m a bit confused by Tom’s explanation of neutropenic sepsis: “your body’s immune response can cause damage to other parts of the body.” That sounds like a description of ‘regular’ sepsis. I was under the impression that neutropenic sepsis was when the body lacks any/hardly any cells to fight the infection and therefore the infection has free reign, and it is the infection that causes the issues and not the a sepsis overreaction (there being nothing to overreact). Certainly that was how it was explained to me when my partner had zero neutrophils post transplant and spent 2 weeks in intensive care with neutropenic sepsis. Can you help in clearing up my confusion please.

  • edited August 2020

    Hi AH67 - thank you for your post.

    Apologies for any confusion - you are entirely correct. Neutropenic sepsis is when someone with a low level of neutrophils gets an infection which their body is unable to fight off. As a result the infection can become septic, leading to an imbalanced immune response.

    I hope that clarifies it. I will amend the description in the post above to avoid any further confusion.

    All the best,

    Tom

  • Am trying to find the letter referred to in the post above about what action a medical team is likely to take on neutropenic sepsis. I'm quite surprised that there is any general procedure. Maybe anything else helpful, too. I'm heartened by the following posts to see that it is at least survivable! My husband is currently fighting it but is very unstable [after 36 hours]. As long as he's where he is, they can't give him the other meds he's been taking, so everything else seems to be getting free reign. No need to go into all of the ancillary matters now, but apart from antibiotics and oromorph ....?

    chelle_16
  • Hi Mel

    I was a frequent flyer with neutropenic sepsis. Addmitted at least every 6 weeks because it was no longer manageable at home.

    Although every ones body responds differently to ailments.

    The team looking after your husband are probably seeking to free him of infection and then gain control of the neutropenia. Im not an expert and our specialist nurses i.e. Hayley can give some more clinical reasoning regarding why they would have restrained the addmition of his normal meds, but my guess would be that some may have an impact on his immunity hence the holding back.

    If well managed neutropenic sepsis can be treated successfully and medications eventualy get re-introduced.

    Wishing your husband well.

    All the best,

    Michelle

    Carol50
  • Hi Mel,

    My apologies - we've recently updated the Anthony Nolan website & the link to that online letter re: neutropenic sepsis was accidentally broken. It has now been restored.

    1) Simply follow this link to the Anthony Nolan letter 👉 https://bit.ly/3rEVFDm

    2) In the two blank areas, add the name of your transplant centre keyworker contact and the name of your transplant centre.

    3) Download, print or show this letter to the medical team when you arrive at your local hospital.

    I hope that is useful. If we can help any further please don't hesitate to get back in touch.

    All the best,

    Tom

  • Thanks Tom, I've now been able to access the letter and see it's content...thank you both for getting back to me so quickly.
    I'm also much reassured by your response, Michelle..I'm repeatedly struck by what extraordinary things the human body and chemistry are as well as the extraordinary skills of the people trained to look after it and deal with it when it goes awry!.

    chelle_16
  • Absolutely no problem Mel.

    I hope things settle down for your husband soon.

    Please get back to us anytime if we can help any further.

    Tom

    chelle_16
  • Hi mel,

    Yes medical knowledge and advancements have come on leaps and bounds. As has the knowledge of our medical personnel both at Anyhony Nolan and in hospitals. The body is really a wonderful and surprisingly very resilient yet complex being. Quite facinating really.

    Best

    Michelle

  • Hi Mel,

    I have no medical training so you need to rely on your husband’s medical team.

    My partner’s neutropenic sepsis set in about a week after the transplant so he was at absolute zero neutrophils when he went to ICU. In the first couple of days he recorded his first neutrophil - a sign of great hope.

    You don’t say in quite what condition your husband is, my partner was on a ventilator and on kidney dialysis so this is only my experience of that type of treatment for neutropenic sepsis . The ICU team had also inserted central lines rather than using the Hickman line to provide drugs and for the dialysis machine. For a number of days the team struggled to get the infection under control (including not being able to identify it or it’s place of origin in his body), but they did keep saying that if they couldn’t identify it they’d take the Hickman line out. After 4 days that happened and it was found to be the cause, or at least the current home of the infection (I’m guessing that with no cleaning and no drugs or blood passing through it, it had become a safe haven). Once that happened the recovery (from the infection) was quick. It struck me that had the removal happened earlier, in his case, there was a chance the recovery would have occurred sooner and the complications of a long stay in ICU avoided.

    If your husband has any lines in him, ask the medical team about what they advise, and is removal an option that may be beneficial. Throughout my partner also had all of his post-transplant drugs provided via the central line.

    My partner was very sick, but did recover. As chelle_16 has said the the body is amazing.

    BUT, as always we must listen to and be guided by the medical team.

    Here’s to a speedy recovery for your husband

    Carol50
  • Thanks AH67 for this. It helps to have some idea of time-frame when things are as serious. ..as well as further insight into how incredible the body is [and our amazing doctors and nurses!]. Thank you for your good wishes too.....keeping hoping! Mel.

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