CION Ameerpet
Paediatric Oncology · Living Through Treatment
Fever & neutropenia during chemo — when to rush to hospital
Medically reviewed by the CION Paediatric Oncology Team · Last reviewed June 2026
If your child is on chemotherapy and their temperature reaches 38.0 °C or above — go to hospital now. Do not wait. Fever during chemotherapy is a medical emergency, even when your child looks well. Call your oncology team immediately or go directly to the nearest emergency department.
When your child is on chemotherapy, their immune system is temporarily weakened — sometimes severely. A fever that a healthy child could fight off on their own can rapidly become life-threatening. This page explains what neutropenia means, what temperature counts as a child chemo fever emergency, and exactly what to do step by step so you feel prepared, not panicked.
- Know the exact temperature threshold — so you never second-guess whether to call
- Step-by-step action plan — from the moment you notice fever to arriving at hospital
- Other warning signs — beyond fever that also need same-day attention
- What happens at hospital — so arriving does not feel frightening
4.8 · 800+ Google reviews · 15,000+ patients treated
17+
Cancer Specialists
on Panel
on Panel
96.9%
Breast Cancer
Survival Rate*
Survival Rate*
15,000+
Patients
Treated
Treated
4.8★
Google Rating
(800+ reviews)
(800+ reviews)
Understanding the risk
Why fever during chemo in kids is different from an ordinary fever
Most parents are used to fevers being a nuisance — a day in bed, some paracetamol, and your child bounces back. During chemotherapy, that picture changes completely. Here is what you need to understand.
Chemotherapy and the immune system. Chemotherapy works by targeting rapidly dividing cells — including cancer cells. But some healthy cells also divide quickly, including the cells inside the bone marrow that produce blood cells. This means chemotherapy temporarily reduces the number of white blood cells circulating in the bloodstream. The specific cells most affected are neutrophils — the first-responder cells that fight bacterial infections.
What is neutropenia? When the neutrophil count falls below a certain level, your child is said to be neutropenic. This is a predictable, expected part of many chemotherapy cycles — it is not a sign that something has gone wrong with treatment. However, it does mean your child has very limited ability to fight off infections during that window, which typically occurs several days after a chemo cycle and lasts for a week or more. Your oncology team will monitor blood counts and can tell you when your child is likely to be in their neutropenic window.
Why fever is the key warning sign. In a neutropenic child, the body cannot mount the usual visible signs of infection — swelling, redness, localised pain. Fever is often the only sign that bacteria have entered the body. By the time the fever appears, infection may already be spreading through the bloodstream. This is why a child chemo fever emergency is taken so seriously: delaying treatment by even a few hours can change the outcome. The medical term is febrile neutropenia — fever (febrile) in a child with a low neutrophil count (neutropenia) — and it is treated as a medical emergency at every paediatric oncology centre in the world.
Fever during chemo kids: the temperature numbers that matter. Your oncology team will give you a specific fever threshold to watch for. The standard guideline used by most paediatric oncology units is: a single temperature of 38.3 °C (101 °F) or above, OR two readings of 38.0 °C (100.4 °F) or higher taken one hour apart. Either reading is enough. You do not need to wait for a higher number. You do not need to wait to see if the temperature comes down. The moment either threshold is reached, act immediately. See also: persistent fever in children and cancer.
Did you know?
International paediatric oncology guidelines recommend that a child with febrile neutropenia receives their first dose of intravenous antibiotics within 60 minutes of arriving at hospital — not after waiting for all test results. This is because sepsis in a neutropenic patient can progress within hours. The sooner treatment begins, the better the outcome. Telling the triage team immediately that your child is on chemotherapy triggers this urgent pathway. Source: International Society of Paediatric Oncology (SIOPE) / national febrile neutropenia management guidelines.
Your action plan
What to do when your child gets a fever during chemotherapy
Follow these steps in order. Do not wait for symptoms to worsen before moving to the next step.
-
1
Take the temperature — correctly
Use a digital thermometer in the armpit or ear (axillary or tympanic). Take two readings if the first is between 37.5 °C and 38.3 °C. Use the same thermometer each time so readings are consistent. Write down the temperature and the time — you will be asked for this when you call the team or arrive at hospital. If the reading is 38.3 °C or above on a single reading, or 38.0 °C on two readings one hour apart, move immediately to Step 2. Do not take a third reading hoping the number will change.
-
2
Call your oncology team immediately
Your paediatric oncology unit should have given you a 24-hour contact number — a nurse helpline, an on-call oncologist, or a specific number on your child's treatment card. Call it now, before leaving for hospital. Tell them: your child's name, the temperature reading and when it was taken, which chemotherapy cycle your child is currently in, and any other symptoms. The team will confirm whether to go directly to their unit or to the nearest emergency department. If you cannot reach the number, go directly to hospital — do not wait for a call-back. The CION team is reachable at 1800 202 8726.
-
3
Do not give fever medicines before calling — unless your team has told you to
Paracetamol and ibuprofen lower body temperature, which can temporarily mask a fever and delay diagnosis. Many paediatric oncology protocols ask parents to call first, before giving anything. If your written protocol says to give paracetamol before travelling, follow that instruction. If you are unsure, call and ask. Ibuprofen is generally avoided during chemotherapy — it can affect platelet function in a child who may already have a low platelet count. Never give aspirin to a child with cancer or on chemotherapy.
-
4
Gather your documents and go
Take your child's treatment summary card, chemotherapy protocol print-out, or hospital-issued red emergency card — whichever document lists your child's current medicines and relevant blood count history. If your hospital issues an emergency letter for parents, have it to hand. Bring any recent blood count results if you have them at home. These documents help the emergency team make decisions quickly, especially if you arrive at a hospital that does not have immediate access to your child's oncology records.
-
5
Tell the triage team immediately — your child is on chemotherapy
As soon as you walk through the emergency department doors, tell the first person you see: "My child is on chemotherapy and has a fever." These exact words are important. Many hospitals have a febrile neutropenia pathway — a fast-track process specifically for children on chemotherapy with a fever. Saying these words should trigger that pathway and get your child assessed quickly. If there is a long queue and you feel your child is being overlooked, repeat this to a nurse or the charge nurse. You are not being difficult — early treatment genuinely matters.
-
6
What happens next — you will not be alone
The hospital team will check your child's observations, take blood from the line (if your child has a central line) or a vein, and check the white blood cell count. If the neutrophil count is very low, or if the team judges the situation is urgent, they will start intravenous antibiotics promptly — often before test results come back. Your child may need to stay in hospital for one or more days while the team confirms the infection is under control and blood counts are recovering. This is standard — it does not mean anything has gone wrong with the cancer treatment itself. The oncology team will liaise with the ward throughout.
12+ Centres in Hyderabad · Pick yours
CION cancer care is closer than you think.
We're never more than 30 minutes away. Same panel of specialists at every centre. Same tumour board reviews. Same NCCN protocols. Pick the closest one and call directly — or let us pick for you.
CION Ameerpet
CION Kukatpally
CION L.B. Nagar
CION Tolichowki
CION Masab Tank
CION Banjara Hills
CION Kompally
CION Balanagar
CION Siddipet
CION Sangareddy
Not sure which centre fits best? Tell us where you are — we'll suggest the closest one with the right specialists.
Help me pick the right centre
Beyond Hyderabad
35+ centres across Telangana & Andhra Pradesh
Travelling for treatment? We may have a centre right where you are.
Telangana
Andhra Pradesh
Don't see your city? Call 18002028726 — we'll find your nearest CION partner centre.
Meet the Specialists
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.
Medical Oncologist
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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.
You deserve a team that walks this journey with you
Our 17 super-specialist oncologists include dedicated paediatric oncology support — with 45-minute consultations, tumor board reviews, and transparent costs. Every family deserves this level of care.
Beyond fever
Other warning signs during chemotherapy — go to hospital the same day
Fever is the most common emergency during chemotherapy for kids, but it is not the only one. The following signs also need urgent assessment — do not wait overnight or until the next scheduled clinic appointment.
Platelet drop
Unusual bruising or bleeding
Unexplained bruises that appear without injury, tiny red or purple pinprick dots on the skin (petechiae), bleeding from the gums or nose that does not stop within a few minutes, or blood in the urine or stool — any of these can signal a platelet count that has fallen dangerously low. The risk of serious internal bleeding is real at very low platelet levels.
Anaemia
Extreme pallor or breathlessness at rest
If your child looks very pale — around the lips, the inside of the eyelids, or the fingernail beds — and is breathing fast or seems short of breath even when sitting still, this may indicate the red blood cell count has fallen to a level requiring a blood transfusion. These symptoms can develop gradually and are easy to miss day to day.
Central line
Redness, swelling, or pain around the line site
If your child has a central venous catheter (Hickman line, PICC, or portacath), any redness, swelling, leaking, or localised pain around the exit site or along the line track needs prompt assessment. A line infection can cause sepsis very quickly in a child on chemotherapy. Also seek same-day advice if the line becomes blocked or dislodged.
Hydration
Persistent vomiting or inability to keep fluids down
Nausea and occasional vomiting are common side effects during and after chemotherapy cycles, and the team will prescribe anti-nausea medicines. But if your child is vomiting repeatedly and cannot keep down fluids, oral medicines, or small sips of water over several hours, they may become dehydrated — and missing prescribed medicines is a clinical concern. Same-day review is needed.
Neurological
Sudden severe headache, confusion, or seizure
A severe headache that is different from anything your child has had before, sudden confusion or unusual behaviour, difficulty speaking, loss of coordination, or a seizure at any point during treatment is a neurological emergency. Call 108 immediately — do not wait to call the oncology team first. These symptoms can have several causes during cancer treatment and all require urgent investigation.
Mouth & throat
Severe mouth sores preventing any eating or drinking
Mild mouth sores (mucositis) are common during chemotherapy. However, if the sores are so severe that your child cannot swallow anything — not even sips of water — they are at risk of dehydration and malnutrition, and may need intravenous fluids and pain management. Speak to the oncology team the same day rather than managing at home and hoping it improves.
This list is not exhaustive. If you are concerned about any symptom during your child's treatment, call your oncology team. You will never be made to feel that you contacted them unnecessarily — that is exactly what the team is there for. At CION, our paediatric team is reachable on 1800 202 8726.
Your child is not alone — and neither are you
We walk this journey with every family. Call our paediatric oncology team or request a callback — we will explain what to expect at every step of treatment.
Real families, real stories
Families who walked this journey with CION
You deserve a team that treats your child as a whole person — not just a diagnosis. Every family at CION receives a 45-minute detailed consultation and a tumor board review.
Real Stories. Real Voices.
15,000+ patients chose CION. Hear from them directly.
These aren't paid endorsements or written reviews. These are video testimonials from real patients and families — recorded on their own phones, in their own words. Pick any one. Watch it. Then decide.
4.8★800+ Google reviews
50+video testimonials
15,000+patients treated
Read all 800+ reviews on Google
Start Your Story. Book Free Consultation.
Common questions
Questions parents ask most about fever during their child's chemotherapy
Pediatric Cancer A–Z
Explore All Pediatric Cancer Topics
Browse our complete library of parent-facing guides, grouped by topic — from warning signs and cancer types to diagnosis, treatment, side-effect care, survivorship and family support.