Oncology Patient Presenting with New Fever Clinical Pathway, Emergency Department and Outpatient Specialty Care – Eligibility for Outpatient Treatment

Oncology Patient with New Fever Clinical Pathway

Eligibility for Outpatient Treatment

To be eligible for outpatient treatment, the child must meet all of the following criteria below in all categories.

Decision to be made in conjunction with Oncology team.

Clinical Features Medical History Social
  • No visible disruption of mucocutaneous barriers
  • Age > 6 mos
  • Tolerating PO
  • Reassuring PE, VS
  • Low concern for bacterial or fungal infections such as bloodstream infection, pneumonia, cellulitis, or UTI
  • No history of:
  • Current neutropenia expected to last > 7 days
  • Surgery within preceding 2 wks, excluding line placement
  • > 15 days of glucocorticoids in preceding 30 days
  • CAR T-cell therapy within the preceding 100 days
  • Allogeneic stem cell transplant within preceding 12 mos
  • Relapsed leukemia not in remission
  • VP shunt, Ommaya reservoir, or other implanted devices at present, excluding ports
  • Trisomy 21
  • Current GVHD therapy
  • Current use of broad-spectrum antibiotics
  • Family able to:
  • Fill levofloxacin prescription
  • Follow up in clinic within 24-72 hrs, sooner if unable to fill prescription
  • Receive daily follow-up phone calls