Assessment of New Fever in the Non-neutropenic Intensive Care Unit Patient
Fever is a common problem in ICU patients. The presence of a fever frequently results in the performance of diagnostic tests and procedures that significantly increase medical costs and expose the patient to unnecessary invasive diagnostic procedures and the inappropriate use of antibiotics. The main diagnostic dilemma is to exclude noninfectious causes of fever and then to determine the site and likely pathogens of those with infections. It should be recalled that antibiotics are not antipyretic agents and that antibiotics should be used only in patients likely to havea bacterial infection. Furthermore, it is important to appreciate that not all patients with infections are febrile. Approximately 10% of septic patients are hypothermic and 35% are normothermic at presentation. Septic patients who fail to develop a temperature have a significantly higher mortality than febrile septic patients.
KeywordsClostridium Difficile Infection Acalculous Cholecystitis Empiric Antibiotic Urinary Tract Obstruction Drug Fever
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