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Updated: Jul 7, 2026
05:12
Portable Thermographic Screening for Detection of Acute Wallenberg's Syndrome
Published on: September 19, 2019
[Fever in Emergency Department: screening for severe disease].
J V San Martín López1, J M Casas Rojo, O Mateo Rodríguez
1Servicio de Medicina Interna, Hospital de Fuenlabrada, Madrid, España. jsanmartin.hflr@salud.madrid.org
Revista Clinica Espanola
|February 16, 2008
Summary
In adult emergency department patients with fever, comorbidity, elevated C-reactive protein, and older age are linked to severe disease. Upper respiratory infections may act as a protective factor against severe outcomes.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Clinical Epidemiology
Context:
- Fever is a common presenting symptom in emergency departments.
- Identifying predictors of severe disease in febrile adults is crucial for timely intervention.
- Previous studies have explored various factors, but a comprehensive model for emergency department patients is needed.
Purpose:
- To identify variables associated with severe disease in adult patients presenting with fever in the Emergency Department.
- To develop a risk score model for predicting severe disease based on identified variables.
Summary:
- An observational study analyzed 11,271 adult patients with fever (temperature >= 37.8°C).
- Severe disease occurred in 27% of febrile patients. Key predictors included comorbidity (OR 3.6), C-reactive protein > 10 mg/dl (OR 1.8), and age (OR 1.02).
- Fever with a probable upper respiratory origin was protective (OR 0.4), while other infection sources increased risk.
Impact:
- The findings aid in risk stratification of febrile adult patients in the Emergency Department.
- A predictive model based on comorbidity, CRP, age, and infection source can guide clinical decision-making.
- Early identification of severe disease can lead to improved patient outcomes and resource allocation.
Related Concept Videos
01:25Increased Body Temperature
A body temperature above 38°C (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in response to an infection or illness.
01:22Methods of reducing fever
The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Pharmacological Methods of Reducing Fever:
01:25Types of Fever
Fever can be triggered by several factors, including infections, nervous system disorders, certain cancers, blood diseases like leukemia, embolism, thrombosis, heatstroke, dehydration, surgical trauma, crushing injuries, and allergic reactions.
Here are the different types of fever:
Here are the different types of fever:
01:26Patterns of Fever
Before understanding the types and patterns of fever, it is essential to know its phases.
01:26Rocky Mountain Spotted Fever
Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
01:27Assessing Body Temperature - Rectal
Rectal temperature measurement is considered the most precise method for assessing core body temperature and typically registers higher than oral temperature. For adults, the rectal thermometer should be inserted 1 to 1.5 inches into the rectum to obtain the most accurate reading.
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...