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Reduced febrile response to bacterial infection in anorexia nervosa patients
C Laird Birmingham1, Deborah M Hodgson, Jonathan Fung
1Eating Disorders Program, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada. clbirm@interchange.ubc.ca
Objective:
To report a reduced febrile response to bacterial infections in anorexia nervosa (AN) patients.
Method:
Four cases were obtained from a retrospective review of charts from the St. Paul's Hospital Eating Disorders Program (Vancouver, Canada). The patients had died or had been admitted to the hospital for treatment of a bacterial infection. In addition, one case was obtained from the Royal Prince Alfred Hospital (Sydney, Australia).
Results:
All patients suffered a bacterial infection during the course of AN. None of the patients had a temperature higher than 37 degrees C during the infectious illness.
Discussion:
The absence of fever in AN may delay the diagnosis of bacterial infection and may be a marker of an impaired immune response. Therefore, alternative methods of investigation are necessary in patients with AN suspected of having a bacterial infection.
Insights
Anorexia nervosa (AN) patients often show a reduced fever response during bacterial infections. This blunted febrile response can delay diagnosis and indicate immune system impairment.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Psychiatry
Background:
- Anorexia nervosa (AN) is an eating disorder associated with significant medical complications.
- Altered immune function is increasingly recognized in individuals with AN.
Observation:
- This study reviewed cases of bacterial infections in patients with AN.
- A consistent finding was the absence of elevated body temperature (fever) during these infections.
Findings:
- Patients with AN experiencing bacterial infections did not exhibit fever, with temperatures not exceeding 37°C.
- This suggests a blunted febrile response to infection in the context of AN.
Implications:
- The lack of fever in AN patients with bacterial infections may impede timely diagnosis.
- This presentation could signify an impaired immune response, necessitating alternative diagnostic approaches.
- Early recognition and investigation are crucial for AN patients suspected of infection.