A prospective study of fever in the accident and emergency department

Body temperature is one of the most commonly performed measurements in the accident and emergency department, and is often used as the basis for clinical decisions. Fever is frequently assumed to indicate infection, but there are few data on unselected patients presenting acutely. We studied 101 consecutive patients with fever (temperature (38 degrees C) among 3991 presentations to two emergency departments in tertiary-care inner city hospitals. The commonest categorical discharge diagnosis, or diagnosis at seven days, was infection (63%). There were no simple clinical tests that could distinguish fever due to infection from other diagnoses. The results suggest that, for patients presenting to an emergency department, pyrexia often indicates infection that may necessitate admission, especially in the elderly.