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CION Cancer Clinics
Suspected sepsis at home: the signs and what to do now | CION Cancer Clinics
If someone with a blood cancer, or on treatment for one, has a fever, uncontrollable shivering, new confusion or suddenly feels very unwell, treat it as possible sepsis. Call 108 or go to the nearest emergency department now. Low white cell counts can hide the usual signs, so small changes count. This page lists what to watch for and what to do. At CION Cancer Clinics, our haematology team supports patients and families through treatment, cost questions and life at home.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What is sepsis, and why does a blood cancer raise the risk?
- What are the signs of sepsis at home?
- What should you do, step by step?
- What should you keep ready at home during treatment?
- Which beliefs delay families from going to hospital?
- What happens at hospital, and what can this page not tell you?
- Common questions about sepsis during blood cancer treatment
!
If you think it is sepsis, go now
If someone with a blood cancer, or on treatment for one, has a fever, uncontrollable shivering, or suddenly feels very unwell, go to the nearest emergency department straight away or call 108. Say "blood cancer, on treatment, possible sepsis" at the door. Do not wait for the morning, do not wait to see if a fever medicine brings it down, and do not wait for a clinic call-back.
The short answer
What is sepsis, and why does a blood cancer raise the risk?
Sepsis is the body's extreme reaction to an infection. Instead of fighting the infection where it started, the body's response starts to harm its own organs. It can become life-threatening within hours, which is why speed matters more than anything else on this page.
Why blood cancer patients are at higher risk
Leukaemia, lymphoma and myeloma affect the white cells that fight infection. Chemotherapy and some other treatments lower those cells further, often for a stretch of time after each cycle. A central line or PICC line, the thin tube left in a vein for treatment, is another way germs can get in.
Why the signs can be quiet
With a low white cell count, the body cannot make its usual response. There may be no pus, no redness around a wound and only a mild fever. An older person may simply become confused or unusually sleepy. That is why families are told to act on small changes.
Who this page does not cover
This page is about recognising sepsis at home and getting to help. It does not explain hospital treatment in detail, and it is not a guide to managing a fever yourself.
Not sure whether this applies to you?
Ask an oncologistWhat to look for
What are the signs of sepsis at home?
Any one of these, in someone with a blood cancer, is a reason to go in. You do not need to see several together.
Fever or shivering
A raised temperature on the thermometer, or shaking chills even if the thermometer reads normal. Check with a thermometer, not by touch.
A temperature that is unusually low can also be a warning sign.Changes in the mind
New confusion, slurred speech, not making sense, or being very hard to wake. Families often notice this before the patient does.
Breathing and heartbeat
Breathing fast, feeling breathless, or a pounding, racing heart while resting.
Skin and urine
Skin that is cold, clammy, pale, blotchy or bluish. Passing very little urine, or none, for most of a day.
Around a line or wound
Pain, redness, swelling or discharge where a central line enters the skin. Shivering during or just after the line is flushed.
Feeling "something is badly wrong"
Patients often say they have never felt this ill. Take that seriously, even when the numbers look ordinary.
In the next hour
What should you do, step by step?
Check the temperature
Use a thermometer and note the reading and the time. If there is no thermometer, do not delay; go by the other signs.
Decide how to travel
Call 108 if the person is confused, breathless, fainting or too weak to sit in a vehicle. Otherwise go by car or auto with someone else driving.
Grab the essentials
The latest blood report, the treatment summary and every medicine. If they are not to hand, leave without them.
Speak up at the door
Tell the triage nurse about the blood cancer, the last treatment date and the possible infection. Ask to be seen quickly.
Let your team know
On the way or once there, phone the treating haematology team so they can speak to the emergency doctor.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Before it happens
What should you keep ready at home during treatment?
- A working digital thermometer, kept in one known place
- A folder with the diagnosis, treatment summary and latest blood report
- A written list of every medicine, including any stopped recently
- Your haematology team's phone number saved on two phones
- The name of the nearest hospital with a round-the-clock emergency department
- A plan for who drives, and who stays with the children, at night
Commonly believed
Which beliefs delay families from going to hospital?
"Let us give a tablet for the fever and see how it is in the morning."
A fever medicine can lower the temperature while the infection keeps spreading. Morning may be too late. Ask your treating team in advance what they want you to do with fever medicines, and go in first.
"The fever is only slight, so it is not serious."
With a low white cell count the body cannot mount a big fever. A small rise, or shivering alone, can mean a serious infection. The size of the fever does not tell you how ill someone is.
"He is only confused because he is old and tired."
Sudden confusion is one of the most common signs of sepsis in older people. It is a change from normal, and it needs a doctor today.
"We do not want to trouble the emergency doctors at night."
Treating suspected sepsis quickly is exactly what emergency departments are for. Doctors would far rather rule it out than see someone late. Going in is never a waste of their time.
Being straight with you
What happens at hospital, and what can this page not tell you?
At the emergency department, the team will check the temperature, blood pressure, pulse and oxygen level, take blood tests and blood cultures, and look for where the infection started. If sepsis is possible in someone with low counts, antibiotics through a drip are usually started quickly, often before the results are back.
What this page cannot tell you
A list of signs is not a diagnosis. Some people with sepsis show only one of these signs, and some people with several of them turn out to have something milder. Only a doctor with test results can tell the difference. This page also cannot tell you how an admission will go or what the outlook is. Those questions belong with the doctors caring for the person.
Medicines at home
Do not start, stop or skip any cancer medicine because of a fever unless your treating team tells you to. Take the medicines with you and let the doctors decide.
Temperature ranges and advice can differ between treatment teams. Ask your own team at the start of treatment what fever reading should bring you in.Questions we are asked
Common questions about sepsis during blood cancer treatment
What temperature should make us go to hospital?
For someone on blood cancer treatment, any fever confirmed on a thermometer is the point to go in straight away. Ask your team for the exact reading they want you to act on and write it on the fridge. Your own team may give you a different instruction, so ask them. Shivering, confusion or feeling suddenly very unwell are reasons to go even with a normal reading.
Can sepsis happen without any fever?
Yes. With a low white cell count, or in older people, there may be little or no fever. The temperature can even drop below normal. Confusion, fast breathing, cold blotchy skin or passing very little urine are warning signs on their own. Do not wait for a fever to appear.
Should we call the haematologist first or go straight to emergency?
If sepsis signs are present, go first and call on the way. Waiting for someone to answer the phone or call back loses time. If the signs are mild and you can reach your team at once, follow their advice, but never let a call delay leaving.
Is it safe to go to a local hospital instead of the cancer centre?
Yes. With suspected sepsis, the nearest emergency department is usually the right choice, because the first treatment is time-sensitive. Tell them about the blood cancer and the last treatment date, and ask them to phone the treating team. A transfer can be discussed once the person is stable.
Can we give paracetamol while we get ready to leave?
Ask your treating team this question at the start of treatment, not during an emergency. A fever medicine can hide the fever the doctors need to see, and some teams prefer you to go in first. Whatever is given, tell the emergency doctor what it was and when.
Does a central line make sepsis more likely?
A line gives germs a route into the blood, so it adds to the risk. Watch the skin where it enters for redness, pain or discharge, and report shivering during or after it is flushed. Keep the dressing clean and dry, and follow the care instructions the nurses gave you.
Will the treatment plan be delayed after sepsis?
Sometimes the next cycle is pushed back so the body can recover, and sometimes the plan continues as before. It depends on the blood counts and how the person recovers. Your haematologist will explain the decision. Do not adjust any treatment yourself while you wait.
How can CION help after a sepsis admission?
Once the person is home and stable, CION's haematology team can review the admission reports, the blood counts and the treatment plan with you. Complex cases are discussed at a tumour board, and the team coordinates with other centres when specialised care is needed. Call the helpline to arrange this.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. A haematology consultation can be booked at any of these centres through one helpline, and your team will tell you where each test or treatment takes place.
Warangal
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Sources
- NICE — Neutropenic sepsis: prevention and management in people with cancer (CG151)
- NICE — Suspected sepsis: recognition, diagnosis and early management (NG51)
- NHS — Sepsis
- Macmillan Cancer Support — Cancer information and support
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Sudden Breathlessness in a Haematology PatientWhen breathing changes suddenly during treatmentWhat to Tell an Emergency Doctor Who Does Not Know YouThe facts to say first at triageGoing to a Local Hospital Instead of Your CentreWhen the nearest emergency department is the right choiceBlood counts during chemotherapyWhy white cells fall after each cycleHaematology EmergenciesEvery blood cancer emergency in one place
Talk to us
Home after an admission and unsure what comes next?
Tell us what has been found so far. CION's haematology team will review the reports with you and help you plan the next step.