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[Fever in intensive care: keep medications in mind at all times]
R R Postema1, G L Ong, H A Bruining
1Afd. Heelkunde, Academisch Ziekenhuis Rotterdam-Dijkzigt.
Abstract:
In two patients, men aged 35 and 69 years admitted postoperatively to the intensive care unit, fever of unknown origin developed. One had been admitted because aspiration was suspected. He had been treated immediately with amoxicillin and clavulanic acid. The other had undergone oesophageal excision and gastric reconstruction because of oesophageal carcinoma and had been subjected to antibiotic decontamination (amphotericin B, norfloxacine en fungizone). No cause for the fever was detected, but it quickly subsided after discontinuation of the amoxicillin-clavulanic acid and the norfloxacine, respectively. When encountering fever of unknown origin in intensive care patients it is always important to think of drug fever.
Insights
Fever of unknown origin in intensive care patients may indicate drug fever. Discontinuing specific antibiotics, like amoxicillin-clavulanic acid and norfloxacin, resolved the fever in two cases, highlighting the importance of considering medication side effects.
Area of Science:
- Intensive Care Medicine
- Clinical Pharmacology
- Infectious Diseases
Background:
- Fever of unknown origin (FUO) is a common challenge in intensive care units (ICUs).
- Identifying the cause of FUO is crucial for appropriate patient management.
- Drug-induced fever is a potential, often overlooked, etiology in critically ill patients.