Over 12 months, 26 malnourished patients had 30 episodes of leukopenia while receiving total parenteral nutrition (TPN). There were 22 episodes of leukopenia associated with high temperatures (>37.8 °C) A TPN-induced septicemia was the cause of fever in one patient. One patient with slight transient fever received no antibiotics, and 21 febrile patients were treated with various broad-spectrum antibiotics. The average duration of leukopenia was 6.9 days, and the average nadir of leukopenia was 789/cu mm. Eleven patients died during or within two weeks of the neutropenic episode. No deaths were related to TPN-induced septicemia. With proper care, TPN can be given to neutropenic patients without additional risk of sepsis.
(JAMA 244:680-681, 1980)