The clinical manifestations of decreased concentrations or abnormal function of neutrophils are the result of infection.
— The relationship of frequency or type of infection to neutrophil concentration is an imperfect one.
— The cause of the neutropenia, the coincidence of monocytopenia or lymphopenia, concurrent use of alcohol or glucocorticoids, and other factors can influence the likelihood of infection.
— Infections in neutropenic persons not otherwise compromised are most likely to result, initially, from gram-positive cocci and usually are superficial, involving skin, oropharynx, bronchi, anal canal, or vagina. However, any site may become infected, and gram-negative organisms, viruses, or opportunistic organisms may be involved.
— There is a decrease in the formation of pus in patients with severe neutropenia. This failure to suppurate can mislead the clinician and delay identification of the site of infection because minimal physical or radiographic findings develop.
— Exudate, swelling, and regional adenopathy are much less prevalent in severely neutropenic patients. Fever is common, and local pain, tenderness, and erythema are nearly always present despite a marked reduction in neutrophils.