Fever in a Child After a Bone Marrow Transplant: Emergency Care Guidelines

Immediate Evaluation Required

This child has received a bone marrow transplant or BMT, and is immunocompromised. This child is at risk of severe infections and needs to be evaluated immediately/STAT in the emergency department within 10 minutes of arrival and moved out of the waiting area as soon as possible.

If this child presents with a fever, please initiate the Bone Marrow Transplant Fever Protocol immediately.

Call CHRISTUS Children's BMT Doctors

210-570-5177

Blood and Marrow Transplant Fever Guidelines

  • Personnel should wear masks in the treatment room
  • Access the port or central line immediately
  • Obtain a blood culture and CBC from the port or central line. Any other workup will depend on the clinical presentation
  • Do not give the patient Motrin (ibuprofen). Tylenol may be given
  • Do not take the patient's temperature rectally or insert anything into the rectum
  • Please call 210-570-5177 and ask for the BMT doctor ASAP

 

Contact the Bone Marrow Transplant Team Immediately

Call the CHRISTUS Children's BMT Physician On Call: 210-570-5177

Ask for the Bone Marrow Transplant or BMT physician.

The BMT team can provide patient-specific guidance, review the child's transplant history, and assist with treatment decisions.

Frequently Asked Questions

Why is a fever after a bone marrow transplant considered an emergency? 
A fever may be one of the first signs of a serious infection in a child whose immune system has been weakened by a bone marrow transplant. Prompt evaluation and treatment are critical.
Does the child need to be seen even if they look well? 
Yes. Call your BMT doctor if your child has a temperature of 100.4O or 100O for two hours. Bone marrow transplant patients can develop severe infections without appearing seriously ill initially. Delays in evaluation and treatment may increase the risk of complications.
Should standard fever protocols be used? 
Follow your ER's emergency protocols while also adhering to the bone marrow transplant-specific precautions and contacting the BMT physician as soon as possible.
What if the child does not have a fever but appears ill? 
Any concerning symptoms in a patient who's undergone a bone marrow transplant should receive prompt urgent evaluation and immediate communication with the BMT team.

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