This patient has developed febrile neutropenia as a consequence of palliative paclitaxel chemotherapy administered 10 days previously. The history and physical suggest herpes zoster infection of the right T-7/8 dermatome. However, a patient with an absolute neutrophil count less than 500 is at high risk for bacterial infection and must be treated emergently with broad-spectrum antibiotics until the leukocyte count recovers. Therefore parental acyclovir and ceftazidime are indicated. Therapy with G-CSF at this time would have little effect on the course of the patient's illness: randomized clinical trials demonstrate that this treatment is not indicated. Studies to date show that the major role for G-CSF is to prevent development of febrile neutropenia in patients receiving chemotherapeutic regimen that has a greater than 40% chance of resulting in febrile neutropenia. Platelet transfusion is restricted to asymptomatic patients with a platelet count <20,000 or thrombocytopenic patients with signs/symptoms of bleeding.