Chemotherapy and Fever: What to Know

Yes, fever can occur during chemotherapy, and it is treated as a medical emergency because it may be the first sign of infection when white blood cells are low. ^[1] Fever during chemotherapy can be life‑threatening, so you should check your temperature if you feel warm, flushed, chilled, or unwell. ^[1]

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Why Chemotherapy Can Lead to Fever

Chemotherapy can lower white blood cells (neutropenia), weakening the body’s defense and raising infection risk, which often shows up first as fever. ^[2] White blood cells normally help protect against bacteria; when their numbers drop after chemo, it becomes harder to fight infections. ^[2] In this setting, chills or a temperature of 38°C (100.4°F) or higher can occur and needs prompt evaluation. ^[3]

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When to Seek Urgent Care

Contact your care team immediately or go to the emergency department if your temperature is 38°C (100.4°F) or higher, or if you have shaking chills. ^[4] Fever during chemotherapy is considered an emergency and you should be seen quickly. ^[5] Call right away if you also develop new cough, sore throat, burning with urination, or redness/warmth/pus at a wound or catheter site. ^[4] Tell the triage staff you’re on chemotherapy so they can prioritize rapid assessment. ^[5]

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What Happens in the Clinic or ER

All fevers after anticancer therapy are managed as possible neutropenic fever, and empiric IV antibiotics are started rapidly within 30 minutes if there are signs of shock, and within 1 hour otherwise. ^{[6] [7]} Clinicians will obtain blood cultures and needed tests but will not wait for results before starting antibiotics. ^[8] Recommended initial IV antibiotics commonly include a broad beta‑lactam (such as piperacillin‑tazobactam, cefepime, or ceftazidime), adjusted for allergies and kidney function. ^[9] Treatment is reassessed frequently as more information becomes available. ^[10]

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How to Cope at Home: Practical Steps

Have a digital thermometer at home and know how to use it; check your temperature whenever you feel unwell. ^[5] Keep your oncology team’s phone numbers handy, including after‑hours contact, so you can call immediately if fever or infection signs appear. ^[5]

• Hand hygiene is essential for you and anyone around you to reduce infection risk. ^[11] Careful, frequent hand‑washing is one of the simplest and most effective prevention methods. ^[11]
• Monitor for infection signs such as new cough, sore throat, burning with urination, and any redness or pus at wounds or catheter sites, and seek care promptly if they occur. ^[4]
• Avoid sick contacts and crowded places when counts are low, and follow any protective guidance your team provides. ^[12]
• Ask your team about preventive strategies, such as growth factors (to boost white blood cells) if you have a history of low counts or prior febrile neutropenia. ^[12]

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Temperature Thresholds and Symptoms to Watch

Fever is defined here as 38°C (100.4°F) or higher, and this threshold should trigger urgent evaluation during chemotherapy. ^[13] Shaking or chills alongside fever raise concern further and warrant immediate contact with your care team. ^[13] Because fever can be the only sign of infection when counts are low, don’t delay seeking help. ^[1]

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Prevention Tips to Reduce Infection Risk

Clean hands thoroughly and regularly, and ask visitors to do the same before contact. ^[11] Follow safe food practices and avoid raw or undercooked foods during periods of low immunity. ^[12] Keep catheter sites clean and check daily for redness, warmth, or drainage, and report changes promptly. ^[4] People receiving chemotherapy are more susceptible to infections, so consistent everyday precautions make a meaningful difference. ^[12]

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Key Takeaways

Fever during chemotherapy especially 38°C (100.4°F) or higher is an emergency because it can signal a serious infection when white blood cells are low. ^[1] Act fast: check your temperature, call your care team, and seek urgent evaluation so antibiotics can be started quickly when needed. ^{[4] [6]} Preventive measures like meticulous hand hygiene and avoiding sick contacts help lower your risk. ^{[11] [12]}