Review microbiologic data to ensure there is no drug-bug mismatch. If a pathogen has been recovered that explains the presentation, therapy can be narrowed accordingly
Repeat blood cultures q48 hours until resolution of fever
If a clinical syndrome becomes evident, modify therapy as per the syndrome, with collection of appropriate samples to identify the organism
The median time for fever to subside is 5 days in hematologic malignancy and 2 days in solid organ tumors
Noninfectious causes of fever should be considered including underlying malignancy, drug fever, venous thrombosis, and others
Candida and Aspergillus species account for most invasive fungal infection in neutropenic patients
Patients determined to be lower risk febrile neutropenia have a low risk of invasive fungal infection and generally should not receive empirical antifungals