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Fever

NEWS calls

Fever with chemotherapy or immunosuppression is neutropenic sepsis until proven otherwise — antibiotics within 1 hour per local policy.

Act now

  1. 1

    If NEWS2 indicates medium or high sepsis risk, follow the sepsis topic.

  2. 2

    Remove or replace suspect cannulae.

Assess

  • Full NEWS2 and sepsis risk (NG253).
  • Look for a source: chest, urine, lines/cannulae, wounds, abdomen, skin, CNS, joints. Recent surgery? New drugs (drug fever)? Transfusion reaction? VTE?

Investigations

  • Blood cultures (peripheral and line), urine dip and culture, CXR, FBC, CRP, U&E, LFTs; source-specific tests.

Manage

  • Antipyretic (paracetamol) for comfort — it does not treat the cause.
  • Antibiotics guided by source, risk band and local microbiology guidance; avoid blind antibiotics in low-risk patients without a source.

Escalate when

  • Rising NEWS2, hypotension, new confusion, or neutropenic patient: senior review immediately.

Written to current guidance (NICE NG253) · sources checked 14 Nov 2026. We watch NICE for updates weekly.

Sources (2)

Reviewed by Aboodee Alhasso, MPharm MRCPharm IP on 14 Nov 2026

Calculators for this

For healthcare professionals, as an aid to clinical judgement — not a substitute for it. Follow your local policy and ask a senior when in doubt.