TY - JOUR
T1 - Nosocomial Febrile Illnesses in Patients on an Internal Medicine Service
AU - Filice, Gregory A.
AU - Weiler, Mary D.
AU - Hughes, Rita A.
AU - Gerding, Dale N.
PY - 1989/2
Y1 - 1989/2
N2 - Febrile illnesses commonly arise in hospitalized patients after admission, but most previous studies have been of specific subsets of febrile illnesses. To provide practical information about the problem as a whole, we studied febrile illnesses arising after admission (nosocomial febrile illnesses [NFIs]) in 123 inpatients of an internal medicine service who had been afebrile for the preceding week. We compared them with 123 randomly selected patients without NFI. Causes of NFI included infections in 83 cases; noninfectious, inflammatory states in 15; malignancy in 12; ischemia in eight; and procedures in three. Evidence for the cause of the NFI was present at onset in at least 110 of the 123 patients. Despite this, antimicrobial agents were administered to 23 (58%) of 40 patients without infections. Thirty-four patients with NFI died; the NFI contributed to death in 26. In contrast, only eight comparison patients died. “Do not resuscitate” status was present in 32 patients with NFI compared with only 12 comparison patients, and 19 (59%) of the former died. The data from this study provide a comprehensive description of NFI arising in hospitalized internal medicine patients, indicate that the occurrence of a new febrile illness signifies a poor prognosis, and provide a rational basis for management.
AB - Febrile illnesses commonly arise in hospitalized patients after admission, but most previous studies have been of specific subsets of febrile illnesses. To provide practical information about the problem as a whole, we studied febrile illnesses arising after admission (nosocomial febrile illnesses [NFIs]) in 123 inpatients of an internal medicine service who had been afebrile for the preceding week. We compared them with 123 randomly selected patients without NFI. Causes of NFI included infections in 83 cases; noninfectious, inflammatory states in 15; malignancy in 12; ischemia in eight; and procedures in three. Evidence for the cause of the NFI was present at onset in at least 110 of the 123 patients. Despite this, antimicrobial agents were administered to 23 (58%) of 40 patients without infections. Thirty-four patients with NFI died; the NFI contributed to death in 26. In contrast, only eight comparison patients died. “Do not resuscitate” status was present in 32 patients with NFI compared with only 12 comparison patients, and 19 (59%) of the former died. The data from this study provide a comprehensive description of NFI arising in hospitalized internal medicine patients, indicate that the occurrence of a new febrile illness signifies a poor prognosis, and provide a rational basis for management.
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U2 - 10.1001/archinte.1989.00390020051011
DO - 10.1001/archinte.1989.00390020051011
M3 - Article
C2 - 2916876
AN - SCOPUS:0024505551
SN - 0003-9926
VL - 149
SP - 319
EP - 324
JO - Archives of Internal Medicine
JF - Archives of Internal Medicine
IS - 2
ER -