Key points about low white cell count and infection during chemotherapy
- low white cell count is called neutropenia
- white cells fight infection
- neutropenia leads to an increased risk of infection
- infection in a neutropenic child can become serious quickly
- call your child's doctor or nurse if your child is neutropenic and has a temperature of 38 degrees Celsius or higher
- it's important to remember that a normal neutrophil count does not necessarily mean your child has normal infection-fighting ability (normal immunity)
Signs of infection in a neutropenic child
Low white cell count is called neutropenia. White cells fight infection.
There are different types of white cells with different tasks. Two of the important types of white cells are:
- neutrophils which help fight bacterial and fungal infections
- lymphocytes which make antibodies and help fight viral and fungal infections
Neutropenia leads to increased infection risk. If your child is neutropenic and gets an infection, they can become seriously ill quickly.
A fever is a sign that an infection may be starting. If you think your child has a fever, you should take your child's temperature. You can buy a thermometer at a pharmacy, or a ward nurse may give you one. An ear (tympanic) thermometer costs more than a digital thermometer.
Your child's doctor or nurse will tell you when your child is likely to be neutropenic and what to do if they have a fever.
It's important to remember that a normal neutrophil count does not necessarily mean your child has normal infection-fighting ability (normal immunity).
Taking your child's temperature during cancer treatment
If you have a digital thermometer, place it under your child's tongue or underarm until it beeps. Then read the number on the small screen.
If you have an ear (tympanic) thermometer, place it in your child's ear until it beeps. Then read the number on the small screen.
Read more about taking your child's temperature
What to do if your child has a temperature during cancer treatment
If your child is neutropenic and has a temperature of 38 degrees Celsius or higher, or is feeling 'not right' and you are concerned, they may have an infection.
You need to:
- phone the hospital and tell your child's healthcare team
- talk to your child's healthcare team before giving your child any medicine to reduce the fever
Normal body temperature is between 36 degrees Celsius and 37.5 degrees Celsius.
A temperature of 38 degrees Celsius or higher is a fever.
If your child is receiving chemotherapy, a fever is serious because they have a low resistance to infection. Always ask for medical advice.
If your child is neutropenic and gets an infection, they can become seriously ill quickly without immediate medical attention.
If your child is neutropenic and has a temperature of 38 degrees Celsius or higher phone the hospital and tell your child's healthcare team.
Neutropenia and a fever
If your child is neutropenic and has a fever, they will most likely need to go to hospital so they can receive antibiotics through a vein (intravenously). Intravenous antibiotics act quickly. A course of antibiotics may take several days to complete. Your child will stay in a room by themselves to protect them from other infections.
Infections during cancer treatment
Measles and chickenpox are particularly dangerous for a child with low infection-fighting ability (low immunity).
Read more about measles and chickenpox in children with low resistance to infection
Symptoms of infection during cancer treatment
If your child has symptoms of infection or they have been close to an infected person, you should phone your child's healthcare team for advice. Also let the healthcare team know if your child is due to go into hospital, day stay unit or clinic and they:
- have a rash or
- have diarrhoea and vomiting or
- have been close to a person with an infection
Your child's healthcare team may reschedule the appointment to another time and place.
Childhood immunisation during cancer treatment
Your child should have flu immunisation every year during treatment but no other immunisations.
Check some information about flu immunisation
After your child's infection-fighting ability (their immunity) has recovered, your doctor will talk with you about catch-up immunisations. Infection-fighting ability usually recovers 4 months after treatment - but is longer after a stem cell transplant.
Acknowledgements
All the pages in the childhood cancer section of this website have been written by health professionals who work in the field of paediatric oncology. They have been reviewed by the members of the National Child Cancer Network (NZ). Medical information is authorised by the National Child Cancer Network Clinical Leader.
