Abstract: |
Fever is a common clinical problem in hospitalized patients. Although the development of fever in a hospitalized patient may be the clinical expression of a community-acquired infection that has completed its incubation period, this chapter focuses on the possible causes of new-onset fever occurring at least 48 hours after hospital admission. The reader, however, should keep other diagnoses in mind and inquire about the patient’s history of travel, pet and animal exposure, hobbies (e.g., gardening, whitewater rafting and other adventure sports), sexual activity, dietary preferences, occupational exposures, recent immunizations, drug (including corticosteroids) and herbal ingestion within the past month, recent contact with febrile or ill individuals, and other epidemiologic factors such as season of the year. Nosocomial fever occurs in 2% to 31% of medical inpatients. The wide range in prevalence rates has been attributed to differences in definition of fever, methods of temperature measurement, age of patients, and type of medical unit. Hospital-acquired fever may be due to an infectious and/or noninfectious cause, either happening alone or concurrently. An etiology can be identified after appropriate workup in 72% to 88% of patients. It is not uncommon for length of stay and resource utilization to be increased due to the management of the febrile episode. © Cambridge University Press (2008) 2015. |