Infections
Chemotherapy can lower the levels of infection-fighting white blood cells, a condition known as neutropenia. Your doctor is going to be most concerned with your level of neutrophils, the most abundant of the different types of white blood cells. These cells contain tiny packets filled with potent chemicals called enzymes that can destroy bacteria when the chemicals are released. Bacteria are the most common source of infection for patients receiving chemotherapy. The normal number of white blood cells in one microliter of blood (a tiny droplet, one millionth of a liter) is between 4,000 and 11,000; the risk of infection is increased when the neutrophil count drops to 1,000 or fewer. If your neutrophil count dips below this number, you might experience chills, fever, or sweats.
If you are feeling unwell in any way after receiving chemotherapy, it’s important to take your temperature. Temperatures from 99°F (37.2°C) to 100°F (37.8°C) are fairly common. But if your temperature rises to 100.5°F (38.1°C) or above, call your doctor or nurse immediately. Fever may be your only sign of an infection. Unless fever is treated promptly, infections can become life-threatening. Make sure you have a good thermometer that is easy to use and read (the digital ones are fine). Also, be sure to have your doctor’s telephone number in case there is a problem.
Treating Infections
Doctors use antibiotics to treat infections. Although most people think of antibiotics as pills, intravenous antibiotics are often recommended for people on chemotherapy. Using intravenous antibiotics knocks out infections until the white blood cell count returns to normal. Depending on a number of factors, including the type of chemotherapy you receive, another approach is to take medicines known as white blood cell growth factors. Growth factors stimulate the bone marrow to replace blood cells affected by chemotherapy. In some patients, these drugs can reduce the risk of getting infections.
Commonly used white blood cell growth factors include filgrastim (Neupogen) and pegfilgrastim (Neulasta). Both of these drugs have to be given by injection. Your doctor or nurse can train you or a caregiver to administer this injection at home if you prefer.
PREVENTING INFECTIONS
You can lower your risk of infection by taking these simple steps:
- Wash your hands often with soap and water, especially after using the toilet and before eating
- Clean cuts and scrapes right away. Use an antiseptic and keep wounds clean and dry until they heal
- Carry alcohol-based sanitizers, such as Purell, with you in case you don’t have access to soap and water
- Be extra careful not to nick or cut yourself when using a razor, knife, or scissors
- Wear protective gloves when gardening or cleaning up
- Avoid contact with cat litter boxes, bird cages, and fish tanks