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Neutropenic fever

What Temperature Means You — Must Go to Hospital?

38.3°C. That is the number. One reading at or above that temperature during chemotherapy means go to your nearest emergency department now — not in the morning, not after one more reading, now.

Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026

  • One reading is enough — 38.3°C on a single reading is the threshold. You do not need to check twice.
  • Do not wait for other symptoms — Fever can be the only sign of a serious infection before it becomes life-threatening during chemotherapy.
  • A lower reading also applies — 38.0°C that does not come down within an hour also meets the threshold. When in doubt, go.
  • Normal fever rules do not apply — Your immune system cannot fight infection the way it normally would when your white cell count is low.
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38.3°C is the threshold, according to NCCN and ASCO guidance. One reading at or above that temperature during or after chemotherapy means go to the emergency department immediately. Do not wait for a second reading. If your thermometer shows 38.0°C and the reading stays there after an hour, that also means go.

If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.

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Do you need two readings, or is one enough?

One reading of 38.3°C is enough. NCCN and ASCO guidance is clear: a single temperature at that level during chemotherapy meets the definition of neutropenic fever and requires immediate hospital assessment.

The second threshold — 38.0°C — applies when the reading stays at that level for a full hour without coming down. If your temperature has been sitting at 38.0°C or 38.1°C and is not falling, do not wait any longer.

If your reading is borderline and you feel well, ask yourself one question: can I get to a hospital within the hour if this rises? If the answer is no, go now while you still can travel easily.

Which reading means what?

ReadingWhat it meansWhat to do
38.3°C or above — one readingNeutropenic fever by NCCN and ASCO definitionGo to emergency department now
38.0–38.2°C sustained for one hourAlso meets the thresholdGo to emergency department now
38.0–38.2°C — single brief readingBorderlineRecheck in 30 minutes; go if it stays or rises
Any reading with shaking chills or rigorsPossible early infection even below thresholdGo if chills are severe; call your oncology team otherwise
Below 38°C but feeling suddenly unwellDo not dismiss itCall your team; describe exactly what you feel
Typically startsDay 7 to 14 after chemotherapy is the highest-risk window, but fever can occur at any point in the cycleDo not assume the risk has passed until your team confirms counts have recovered

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Common questions

Frequently asked questions

What if I feel fine but the thermometer reads 38.3°C?

Go anyway. Feeling well is not reassurance during chemotherapy. When your white cell count is low, your body may not be able to produce the usual signs of serious infection — the shivering, the aches, the obvious unwellness — until the infection has progressed further. The temperature reading is the early warning. Act on the number, not on how you feel.

Should I take paracetamol to bring the temperature down before going?

Do not take paracetamol or any fever-reducing medicine before you leave for hospital. It will lower the reading and make it harder for the emergency team to assess how serious the infection is. If the team gives you something once you arrive, that is different — they will have already recorded your temperature. At home, before you leave, do not take anything.

What if I am not sure my thermometer is accurate?

Retake the reading once, holding the thermometer still and keeping your mouth closed for an oral reading. If a second reading is 38.3°C or above, go. If you genuinely cannot trust your thermometer and your reading is 38°C or above, that uncertainty is itself a reason to go to hospital rather than stay home and wonder.

What should I say when I arrive at the emergency department?

Tell the triage nurse immediately that you are on chemotherapy and have a fever. Use the words 'neutropenic fever' if you know them — this changes how quickly you are triaged. You will have blood tests to check your white cell count, blood cultures to look for infection, and a clinical assessment. Saying you are on chemotherapy at the desk, before you sit down, triggers the right pathway in any hospital with oncology services.

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