Which Days Are You — Most at Risk of Infection?
Days 7 to 14 after each chemotherapy cycle are when your white cell count falls to its lowest — a period called the nadir. During these days, an ordinary infection can become a medical emergency within hours.
Medically reviewed by Dr. Naresh Gundu, Medical Oncologist, MBBS (Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar) · DNB Internal Medicine (Sir Gangaram Hospital, New Delhi) · DM Medical Oncology (AIIMS) · Last reviewed September 2026
- Days 7–14 are the danger window — Your white cell count falls to its lowest around this time after each cycle.
- Fever in this window means hospital now — Not a call tomorrow. Not wait-and-see. Go to your nearest emergency department.
- You may feel fine and still be at high risk — Low white cells cause no symptoms of their own — fever is often the only warning.
- The window repeats every cycle — After your counts recover, the next cycle starts the clock again from day 1.
on Panel
Survival Rate*
Treated
(800+ reviews)
Days 7 to 14 after each chemotherapy cycle carry the highest infection risk. This is when your white cell count reaches its lowest point, a period called the nadir. During these days, any fever or feeling of sudden illness means going to hospital immediately — not calling in the morning, not waiting to see if it improves.
If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.
Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. Each centre also names the areas it serves, so you can place it without a map. Consultation and day-care Chemotherapy run at every one of them.
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Not sure whether this counts as an emergency?
Call the helpline. It is always better to check than to wait.
What should you do differently on days 7 to 14?
- Check your temperature every morning and every evening, and any time you feel unwell.
- Keep your CION emergency helpline number saved on your phone and easy to reach.
- Avoid large crowds, enclosed public spaces, and anyone who has a cough, cold, or fever.
- Wash your hands before eating and after any contact with other people.
- Avoid raw or undercooked food during this window — ask your team what foods to avoid.
- Do not delay going to hospital because it is night or a weekend — infection does not keep business hours.
- Tell any other doctor, dentist, or pharmacist that you are in a chemotherapy nadir period.
How does infection risk change across your chemotherapy cycle?
| Feature | Days 1–6 | Days 7–14 (nadir) | Days 15 onwards |
|---|---|---|---|
| Infection risk | Moderate | Highest point of the cycle | Falling as counts recover |
| New fever | Call your team today | Go to hospital now — do not wait | Call your team today |
| Sudden chills or feeling very unwell | Call your team today | Go to hospital now | Call your team today |
| Mild cold symptoms | Tell your team at next contact | Call your team immediately | Tell your team at next contact |
| Typically starts | From day 1 of each cycle | Around day 7 after each cycle | Around day 14–21, varies by regimen |
Explore 69 more Blood Counts, Infection, Fever & Emergencies topics
Low White Cells, Neutropenia & Infection
- A Printable Neutropenia Safety Card
- Avoiding Infection During the Low-Count Days
- Bone Pain After Growth Factor Injections
- Can You Go Out When Your Counts Are Low?
- Foods That Are Said to Raise White Cells
- Getting to Hospital Fast From a District
- Growth Factor Injections to Raise Your Counts
- How to Take and Record a Temperature Properly
- Low White Cell Count During Chemotherapy
- Neutropenia in Children on Chemotherapy
- Neutropenic Fever: A Medical Emergency
- Preventive Antibiotics During Chemotherapy
- Recovering Counts Between Cycles
- Should You Take Paracetamol for a Fever?
- Signs of Infection to Watch For
- Understanding Your Blood Count Report
- Visitors When Your Counts Are Low
- What Happens When You Go In With Neutropenic Fever?
- What Is Neutropenia?
- What Is an Absolute Neutrophil Count?
- What Temperature Means You Must Go to Hospital?
- Which Days Are You Most at Risk of Infection?
Blood Transfusion & Donor Arrangement
Emergencies & Red Flags
- A Printable Emergency Action Card
- Bleeding That Will Not Stop
- Breathlessness: When It Is an Emergency
- Chemotherapy Emergencies: The Complete Red-Flag List
- Chest Pain During Chemotherapy
- Confusion, Drowsiness or Fits
- Emergency Contacts: Who to Call and When
- Fever: The Number One Emergency
- Going to a Different Hospital in an Emergency
- Leg Swelling and Calf Pain
- Not Passing Urine or Passing Very Little
- Problems With Your Port or Line
- Severe Mouth Pain Stopping Fluids
- Severe Pain That Is Not Controlled
- Swelling of the Face, Lips or Throat
- Uncontrolled Vomiting or Diarrhoea
- What to Keep Ready at Home for an Emergency
- When to Call the Helpline vs Go Straight In
Fever During Chemotherapy
- A Printable Fever Action Plan
- Can You Wait Until Morning With a Fever?
- Fever After the Course Has Finished
- Fever During Chemotherapy: What to Do Right Now
- Fever When You Cannot Reach Your Team
- Fever With Chills and Rigors
- Fever With No Other Symptoms
- Fever in a Child on Chemotherapy
- How Long Will You Be Admitted for a Fever?
- Is 99, 100 or 101 Degrees an Emergency?
- Preventing Infection to Avoid Fever Episodes
- What to Carry to Hospital With a Fever
- What to Tell the Hospital When You Call
- Why Fever Is Treated as an Emergency
HUB — Low Blood Counts, Infection and Fever During Chemotherapy
Infection Prevention at Home
Low Platelets & Bleeding
- A Printable Bleeding Red-Flag Card
- Arranging Platelet Donors
- Bleeding Gums and Nosebleeds
- Bruising Easily During Chemotherapy
- Dental Work and Procedures With Low Platelets
- Everyday Precautions With Low Platelets
- Foods That Are Said to Raise Platelets
- Low Platelets During Chemotherapy
- Painkillers to Avoid When Platelets Are Low
- Platelet Transfusion: What to Expect
- What Platelet Count Is Dangerous?
Vaccination During & After Chemotherapy
Still not sure what applies to you?
Send your reports across and a senior medical oncologist will go through what they mean, what is known, and what the options actually are.
Frequently asked questions
How do I know which day of my cycle I am on?
Day 1 is the day you receive chemotherapy. Count forward from that date. If your cycle runs every 21 days, days 7 to 14 of that 21-day period are your highest-risk window. Ask your team to write down the nadir dates for each upcoming cycle before you leave the clinic, so you are not calculating under pressure when you feel unwell. Some teams provide a printed calendar — if yours does not, ask for one.
Is the nadir always days 7 to 14?
Days 7 to 14 is the most common pattern, but the exact timing depends on which drugs are in your regimen. Some cause the nadir earlier, some later. Your oncology team can tell you when to expect your lowest point for your specific treatment. The principle is the same regardless of timing: know your window in advance, and treat any fever during it as an emergency that needs hospital assessment the same day.
Can I tell from how I feel that my white cells are low?
Usually not. Low white cells do not cause symptoms of their own. You can be at your most vulnerable and feel almost completely normal. This is why knowing your nadir dates matters more than monitoring how you feel day to day. Fever is often the only early warning that infection has taken hold, which is why any fever on nadir days means go to hospital rather than wait and watch.
What happens when I arrive at hospital with a fever during chemotherapy?
Tell the triage team immediately that you are on chemotherapy and in your nadir window. This changes your priority. Blood tests will check your white cell count and look for signs of infection, and your team will act quickly. You do not need to know what infection you have before going — finding that out is exactly what the assessment is for. Going promptly rather than waiting is what protects you.
Chemotherapy Topics
Browse our complete chemotherapy guide — 1133 pages on side effects, medicines, cost, daily life and care in Hyderabad. Tap any topic to read more.