PGY1 Colin Bergstrom published a Teachable Moment in JAMA Internal Medicine today.
Titled, ”Management of Patients With Febrile Neutropenia”, it discusses that some patients with low risk neutropenic fever can be managed as outpatients after a period of observation in the hospital. The MASCC score can be used to make this decision:
There are 2 caveats: first, febrile neutropenia remains a “medical emergency”—all patients must present to a clinic or an emergency department, and prompt administration of antibiotics within an hour of triage is crucial. Second, no risk score can replace clinical judgment, and the clinician must consider factors such as ability to tolerate oral intake, as well as patient access to a caregiver, telephone, and transportation, while making the decision for outpatient therapy.
Congrats to Colin, and co-authors Dr. Nagalla and Arjun.