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Fever 

Chapter:
Fever
Author(s):

Sarah Morgan

DOI:
10.1093/med/9780190865412.003.0035
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date: 18 November 2019

This chapter focuses on evaluation of a patient in the intensive care unit who develops fever in the setting of an indwelling central line and urinary catheter. Focus is on the development of a differential including central line associated blood stream infection, catheter-associated urinary tract infection, and hospital-acquired pneumonia as the most likely etiology of the patient’s decompensation. Emphasis is on rapid source control and treatment to control sepsis and decompensation to shock. Key management steps include consideration of the most likely sources of infection in the patient who develops fever while in the intensive care unit; securing a complete blood count, lactate, and blood cultures prior to empiric antibiotics; the rapid source control with removal and, if needed, replacement of indwelling lines; and administering appropriate empiric antibiotics within 6 hours of diagnosis of infection.

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