Can I Do a Rectal Exam in a Neutropenic Patient?

Abstract

Patients with pathologically low neutrophil counts, or neutropenia, can present a diagnostic and management challenge in the emergency department (ED). One diagnostic tool, the digital rectal exam (DRE), has historically been discouraged in neutropenic patients due to the concern that it may lead to bacterial translocation and subsequent bacteremia; however, evidence to support this position is lacking. Certain circumstances may justify its use if other lower-risk testing modalities are not readily available.