What are signs of infection in people with cancer?

It’s important to watch for early signs of infection and tell your health care team about them right away. This way treatment can be started as early as possible. This is most important for people who have a low white blood cell count. This is discussed in How does your body normally resist infections?

Signs and symptoms of an infection might include:

  • Body temperature of 100.5º F or higher (a fever) taken by mouth
  • Shaking chills or sweats (often goes along with fever)
  • Sore throat
  • Sores or white coating on your tongue or in your mouth
  • Cough or shortness of breath
  • Nasal congestion
  • Burning or pain when urinating; bloody or cloudy urine
  • Redness, swelling, drainage, or warmth at the site of an injury, surgical wound, or vascular access device (VAD), or anywhere on the skin including the genital and rectal areas
  • Pain or tenderness in the stomach or abdomen (the belly)
  • Stiff neck
  • Sinus pain, ear pain, or headache
  • Swelling or redness anywhere

Fever is especially important because it’s often the first sign of an infection in people with cancer. You should have a thermometer to check your temperature – you can’t rely on how you feel to know when you have a fever. Patients may be told to call their doctor or nurse if they have a temperature of 100.5º F or higher, or if they have other signs and symptoms of infection. Don’t take medicines to reduce your fever (such as Tylenol®, Advil®, Motrin®, or aspirin) without checking with your doctor first. Ask your doctor what you should do and when you should call. Be sure you know how to reach your health care team after hours, including nights and weekends.

Key things you need to know

It’s important for people with cancer and their families and friends to know these things:

  • Your risk for infection
  • How long your immune system is likely be weak after treatment
  • How to take your temperature the right way, when to check it, and how often to check it
  • When to report a fever or other signs and symptoms of infection to the doctor or nurse
  • The importance of hand washing and hygiene for the patient and the people they come in contact with
  • How to take good care of your mouth and check for sores and signs of infection
  • How to clean cuts, scrapes, or other breaks in the skin and keep them clean to help prevent infection
  • The importance of cleaning around the anus after each bowel movement, using moist towelettes or baby wipes
  • Good care of IVs and central venous catheters (CVCs, like ports and PICC lines)
  • Where to look for signs of infection (skin, mouth, and CVC sites)
  • The importance of good nutrition, a balanced diet, and drinking plenty of fluids
  • The importance of sleep and exercise
  • The need to take medicines as prescribed
  • Being sure the doctor knows about all medicines you’re taking (prescription, over-the-counter, vitamins, herbs, and supplements) – keep a list and update it at each doctor visit
  • Ways to prevent dryness of the skin and mucous membranes
  • You need to talk with your health care team or doctor before getting vaccinated (immunized) and before getting close to children or adults who have recently had vaccinations. (See Vaccination During Cancer Treatment for more on this.)

Review these points with your doctor or nurse before and during treatment to get the information you need. Double check with them on how you should handle these things and find out if there are any special steps you should take during cancer treatment.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.