Serveur d'exploration Hippolyte Bernheim

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FEVER IN THE IMMUNOCOMPROMISED HOST

Identifieur interne : 000777 ( Main/Exploration ); précédent : 000776; suivant : 000778

FEVER IN THE IMMUNOCOMPROMISED HOST

Auteurs : Moss Mendelson

Source :

RBID : ISTEX:5011F5D1F5B61D75C78093D3085E93021F43524F

English descriptors

Abstract

The immunocompromised patient is at risk for developing a wide variety of life-threatening infectious disease. Predicated on the underlying immune system defect, many diverse microbes, including those handled routinely by the immunocompetent host, can become pathogens. Fever is often the sole finding, and the incidence of serious disease in this group of patients is high. Data on emergency department (ED) utilization rates by immunocompromised patients are not well documented. One study found that 5 of ED patients had a cancer history. Of those, 43 had an oncology-related visit and, of those with an oncology-related visit, 17 presented with fever.53 Another study of heart and lung transplant patients identified fever as the most common reason for an ED visit (37).52 HIV disease and increasing success in transplant medicine, cancer therapy, and rheumatologic therapy have contributed to the increased prevalence of immunocompromise in the general population. Emergency medicine physicians should develop a systematic approach for patients with compromised immune systems who present with fever, including historical and physical findings pertinent to these patients, with attention to details that are atypical or specific to the immunocompromised state; a diagnostic work-up applicable to most patients with immune system dysfunction; a knowledge of common clinical scenarios of immunosuppression, focusing on unique presentations; and treatment strategies, including disposition options.

Url:
DOI: 10.1016/S0733-8627(05)70032-8


Affiliations:


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Le document en format XML

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<term>Escherichia coli</term>
<term>Febrile</term>
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<div type="abstract">The immunocompromised patient is at risk for developing a wide variety of life-threatening infectious disease. Predicated on the underlying immune system defect, many diverse microbes, including those handled routinely by the immunocompetent host, can become pathogens. Fever is often the sole finding, and the incidence of serious disease in this group of patients is high. Data on emergency department (ED) utilization rates by immunocompromised patients are not well documented. One study found that 5 of ED patients had a cancer history. Of those, 43 had an oncology-related visit and, of those with an oncology-related visit, 17 presented with fever.53 Another study of heart and lung transplant patients identified fever as the most common reason for an ED visit (37).52 HIV disease and increasing success in transplant medicine, cancer therapy, and rheumatologic therapy have contributed to the increased prevalence of immunocompromise in the general population. Emergency medicine physicians should develop a systematic approach for patients with compromised immune systems who present with fever, including historical and physical findings pertinent to these patients, with attention to details that are atypical or specific to the immunocompromised state; a diagnostic work-up applicable to most patients with immune system dysfunction; a knowledge of common clinical scenarios of immunosuppression, focusing on unique presentations; and treatment strategies, including disposition options.</div>
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