Infection and chemotherapy

Each person's individual medical profile and diagnosis is different. So is their reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team the possible side effects of treatment before the treatment begins.

Many chemotherapy medicines can damage the bone marrow. That's where blood cells are made. For most chemotherapy medicines, this effect is temporary and the bone marrow recovers. White blood cells are the cells that fight many types of infections. Because of that, chemotherapy can leave you at risk for infection. The white blood cell most critically impacted by chemotherapy is called the neutrophil. It fights bacterial infections. Infections may come from bacteria living in your own body that aren't normally a problem, such as those on your skin and in your mouth, intestines, and genital tract. Sometimes the source of an infection is unknown. Infections can happen to people even when they are very careful. If you are fighting infections, you may be given a medicine to boost your white blood cell count after chemotherapy.

How can I help prevent infections?

The following tips may help reduce your risk for infection:

• Wash your hands often throughout the day. Be sure to wash before eating, after using the bathroom, and after touching animals. Wash with soap and clean, running water for at least 20 seconds. Scrub your hands well. Be sure to scrub the backs of your hands, your fingernails, and between your fingers. If you don't have soap and water, use antibacterial hand gel containing at least 60% alcohol. 

• Clean your rectal area gently but thoroughly after each bowel movement. Talk with your healthcare provider if the area becomes irritated or bleeds due to hemorrhoids or ulcers.

• Stay away from people who are sick with contagious illnesses. That includes those with a cold, the flu, measles, or chickenpox.

• Stay away from crowds.

• If you have to be around a crowd, it's a good idea to wear a mask.

• Stay away from children who have recently been given "live virus" vaccines, such as chickenpox. They may be contagious to people with a low blood cell count. Oral polio vaccine (OPV) is also a live virus. While it is not currently used in the U.S., it is still used in other countries. Because of that, if you travel internationally, you should also stay away from children who have recently been given oral polio vaccine. 

• Try to prevent accidents and injuries. Be careful not to cut yourself in any way, including the cuticles of your nails. Don't get manicures or pedicures at a salon. Consider using an electric shaver instead of a razor to prevent cutting yourself while shaving.

• Wear shoes at all times to protect your feet. Don't wade in ponds, lakes, or rivers.

• Clean cuts and scrapes right away with warm, soapy water and an antiseptic. Cover the area with a clean bandage.

• To protect your mouth and gums, brush your teeth twice a day with a soft-bristle toothbrush. Ask your healthcare provider if it's OK to floss.

• Don't squeeze or scratch pimples.

• Take a warm (not hot) bath, shower, or sponge bath every day. Pat your skin dry; don't rub it.

• Use lotion if your skin becomes dry.

• Don't use tampons or vaginal suppositories.

• Stay away from animal litter boxes and waste. Also avoid bird cages and fish and turtle tanks.

• Stay away from standing water, such as in bird baths, flower vases, or humidifiers.

• Wear gloves when gardening or cleaning up after others, especially small children. Wash your hands when you're finished.

• Talk with your healthcare provider before getting any type of immunization or shot, such as flu or pneumonia shots.

• Don't eat raw fish, seafood, meat, or eggs. Cook food properly. Wash fresh fruits and vegetables. Ask your healthcare provider if you should follow any other dietary restrictions.

• Don't share plates, cups, utensils, food, towels, or makeup.

What are the symptoms of an infection?

If you have any of these symptoms, consider it a medical emergency. Contact your healthcare provider right away before taking any medicines. If you are unable to reach your healthcare provider, go to the emergency room. Infections can spread rapidly in a person with a low white blood cell count. Signs and symptoms of a possible infection include:

• Fever of 100.4°F (38°C) or higher, or as advised by your healthcare provider

• Chills, especially chills that cause your body to shake

• Sweating

• Earaches, headaches, or a stiff neck

• Blisters on the lips or skin

• Mouth sores

• Toothache

• New cough or shortness of breath

• Sore throat

• Sinus pain or pressure

• Loose bowel movements (diarrhea)

• Frequent rush to urinate, cloudy or bloody urine, or burning with urination

• Unusual vaginal discharge or itching

• Redness, swelling, drainage, or tenderness, especially around a wound, sore, ostomy (an artificial opening in the abdomen), pimple, rectal area, or catheter site

• Belly pain