crsheader Index Fever in a Neutropenic Child

What is neutropenia?

Neutropenia is an abnormally low number of white blood cells (neutrophils). White blood cells protect the body from infection.

Why is fever in a neutropenic child a concern?

Children with neutropenia tend to get infections easily because their white blood cell count is too low to fight off germs, such as bacteria. Most of these infections occur in the lungs, mouth, throat, sinuses, and skin. Some children get gum infections, ear infections, or infections of the urinary tract, colon, rectum, or reproductive tract.

Without enough neutrophils, infections can quickly become life threatening. A fever is often the first sign of an infection.

What is the cause?

Neutropenia may be caused by:

  • leukemia
  • chemotherapy or radiation therapy
  • an infection such as mononucleosis or tuberculosis
  • not having enough vitamin B-12 or folate (folic acid) in the diet
  • an autoimmune disease such as lupus

What are the symptoms?

Symptoms include:

  • frequent fevers
  • mouth sores
  • shortness of breath
  • diarrhea

How is it diagnosed?

A healthcare provider will review your child’s symptoms, ask about medical history, and examine your child. Your child will have one or more blood tests. If the child’s blood tests show neutropenia, your child may also have a bone marrow aspirate test to find out what type of neutropenia your child has.

How is it treated?

The two main treatments for neutropenia are:

  • antibiotics to fight infection
  • drugs called colony-stimulating factors to help the bone marrow make neutrophils

Some children may need a bone marrow transplant.

How can I prevent fever in a child with neutropenia?

There is no way to prevent fever in a child with neutropenia. If your child has been diagnosed with neutropenia, your child should be seen immediately if he or she develops a fever.

When should I call my child’s healthcare provider?


  • Your child develops a fever.
  • Your child is acting very sick.

Call during office hours if:

  • You have other questions or concerns.

Developed by Robert Brayden, MD, Professor of Pediatrics, University of Colorado School of Medicine Published by RelayHealth.
Last modified: 2008-08-11
Last reviewed: 2010-09-16 This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. References
Pediatric Advisor 2011.4 Index
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