When you have neutropenia, there are things you can do to prevent infection. These safety measures are called neutropenic precautions.

Neutropenia is a blood condition involving low levels of neutrophils, a type of white blood cell. Neutrophils fight infection by destroying harmful germs. Without enough neutrophils, you’re more likely to develop infections.

Usually, neutropenia occurs after:

  • chemotherapy
  • radiation therapy
  • taking certain medicines

After chemotherapy, neutropenia often develops after 7 to 12 days. This period may be different depending on the cause of neutropenia. Your doctor can explain when you’re most likely to have it.

While you’re neutropenic, you’ll have to follow neutropenic precautions when you’re at home. If you’re at the hospital, the staff will also take steps to protect you.

Neutropenic isolation

If you have severe neutropenia, you might need to stay in a hospital room. This is called neutropenic isolation or protective isolation.

Neutropenic isolation protects you from germs. You’ll need to stay isolated until your neutrophil levels return to normal.

Not everyone with neutropenia needs to be isolated. Your doctor will decide if it’s the best choice for you.

They’ll consider several factors, including the cause and severity of neutropenia, as well as your overall health.

Guidelines for neutropenic precautions

When you’re at the hospital, doctors and nurses will take steps to keep you safe. The hospital staff will:

  • Place a notice on your door. Before entering your room, everyone needs to follow certain steps to protect you. This notice explains what they should do.
  • Wash their hands. The staff will wash their hands with soap and water before entering and leaving your room. They’ll also wear gloves.
  • Leave reusable equipment in your room. Thermometers and other reusable devices will be kept in your room. You’ll be the only person who uses them.
  • Give you specific foods. When you’re neutropenic, you can’t eat foods that might have bacteria, like unwashed fruit or rare-cooked meat. The staff might put you on a neutropenic diet.
  • Avoid rectal medical procedures. The rectal area is extremely sensitive, so the staff won’t give you suppositories or enemas.

Talk to your doctor or nurse if you’re concerned about these rules.

Neutropenic precautions at home

If you have mild neutropenia, you may stay at home until your neutrophil levels return to normal.

However, it’s still important to protect yourself from germs. Here’s what you can do at home:

  • Stay clean. Wash your hands often, including before and after eating or using the bathroom. Shower daily, being sure to clean sweaty areas like your feet and groin.
  • Ask others to wash their hands. If friends and family want to visit, ask them to wash their hands often.
  • Have safe sex. Generally, it’s recommended to avoid intercourse. If you do have sex, use a water-soluble lubricants.
  • Avoid sick people. Stay away from anyone who is sick, even if they have a mild cold.
  • Avoid recently vaccinated people. If a child or adult just got a vaccine, don’t come close to them.
  • Stay away from large crowds. Avoid public transportation, restaurants, and stores. You’re more likely to catch germs in large crowds.
  • Avoid animals. If possible, avoid them completely. Don’t touch animal waste like dog poop or cat litter.
  • Prevent constipation. Straining from constipation can irritate the rectal area. To avoid constipation, eat enough fiber, and drink five to six glasses of water each day.
  • Avoid live plants. If you must garden, use gloves.
  • Don’t use tampons. Tampons pose a risk for toxic shock syndrome and infection. It’s best to use pads.
  • Practice good oral care. Brush your teeth after eating and before bed. Use a soft toothbrush and brush gently.
  • Wear sunscreen. To prevent sunburn, wear sunscreen SPF 15 or higher.
  • Keep your catheter clean. If you have a central catheter, make sure it’s always dry and clean. Look for redness and pain each day.
  • Avoid cuts. Try your best to avoid injuries like cuts and scratches. Don’t use sharp objects, and be sure to wear gloves while cleaning.
  • Avoid dental work and vaccines. Always ask a doctor first.

Food safety for those with neutropenia

While you’re neutropenic, your body may have a hard time fighting foodborne illnesses.

You’ll need to be extra careful of what you eat. Some foods are more likely to have harmful germs.

Practice kitchen hygiene

Wash your hands before and after preparing food and eating.

Use clean utensils, glasses, and plates. Wash them after each use.

Before eating fresh fruits and vegetables, wash them well.

Avoid uncooked and raw foods

Uncooked and raw foods might contain infection-causing bacteria. You should avoid:

  • raw or unwashed fruits and vegetables
  • raw or undercooked meat, including beef, pork, chicken, and fish
  • uncooked grains
  • raw nuts and honey

To destroy any germs, cook meat and eggs until they reach a safe internal temperature. Use a food thermometer to check.

Avoid cross-contamination

When you’re preparing food, keep raw meat away from cooked foods.

Don’t share food or drinks with other people.

Avoid self-serve stations like bulk food bins, buffets, and salad bars.

When to see a doctor

While you have neutropenia, go to your follow-up appointments. Your doctor needs to check if your neutrophil levels are back to normal.

You should also see your doctor if you think you’ve been exposed to germs.

If you suspect an infection, get medical help immediately. Infections that occur during neutropenia are life-threatening and require emergency care.

Signs of infection include:

Check your temperature twice a day. Sometimes fever might be the only sign of infection during neutropenia.

MEDICAL EMERGENCYIf you have a fever of 100.4°F (38°C) or higher, or notice any other symptoms, go to an emergency room.

The takeaway

If you have severe neutropenia, you’ll need to stay in a hospital room. Doctors and nurses will take extra steps to keep you safe.

If you’re at home, you’ll need to follow various precautions. These include practicing good hygiene, staying away from crowds, and avoiding food that might have germs.

When you’re neutropenic, any sign of infection should be taken seriously. Go to an emergency room if you have symptoms like fever, diarrhea, or chills. Infections that develop during neutropenia are life-threatening.