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Fever in the intensive care unit

B A Cunha1, K W Shea

  • 1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, USA.

Infectious Disease Clinics of North America
|March 1, 1996
PubMed
Summary

Fever in the ICU requires careful evaluation to determine the cause, as treatments vary widely. Avoid routine fever work-ups and prolonged antibiotics for unproven infections in critically ill patients.

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Postgraduate medicine·2016

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Internal Medicine

Background:

  • Fever is common in Intensive Care Units (ICUs) with diverse infectious and non-infectious origins.
  • Accurate diagnosis of fever's cause is vital, as some conditions are life-threatening and others require no intervention.
  • Evaluating febrile ICU patients necessitates understanding common and rare causes, risk factors, and diagnostic limitations.

Purpose of the Study:

  • To emphasize the importance of a tailored diagnostic approach for fever in ICU patients.
  • To guide clinicians in appropriate fever evaluation and antibiotic stewardship.
  • To advocate against routine, non-specific fever work-ups and prolonged empiric antibiotic use.

Main Methods:

  • Review of common infectious and non-infectious causes of fever in the ICU.
  • Emphasis on clinical assessment, historical data, and epidemiological factors.
  • Discussion of diagnostic techniques, their interpretation, and limitations.

Main Results:

  • Routine fever work-ups are not advocated due to patient variability.
  • Antibiotics should be withheld if no overt infection is found initially.
  • Empiric therapy may be used in unstable patients but should be stopped if infection is not evident.

Conclusions:

  • A thorough understanding of potential etiologies and diagnostic tools is essential for managing febrile ICU patients.
  • Judicious use of antibiotics, avoiding prolonged treatment for unproven infections, is crucial.
  • Individualized patient assessment should guide the extent of fever evaluation.

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