Neutropenic Fever

The management of neutropenic fever is quite algorithmic, and nicely outlined here. Major points include: a) fever is defined either as one temp over 38.3 or persistent temps >1hr over 38.0, b) neutropenia means an ANC <500 once or anticipated ANC <500 over the next 48 hours, and c) start with cefepime unless you're prompted to add vancomycin for some reason.

1. What is the difference between typhlitis and neutropenic colitis?

Typhlitis is just a subset of neutropenic enterocolitis that affects mainly the cecum and terminal ileum. They both occur due to gut bacteria translocation from immunosuppression. They are managed the same way, which is similar to neutropenic fever. Basically, treat with antibiotics until they're no longer fevering or neutropenic, then either de-escalate to cipro/metro for 14 days if they weren't bacteremic, or continue IV antibiotics for 14 days post-recovery of neutrophils for 14 days if they were bacteremic.