FEVER IN THE IMMUNOCOMPROMISED HOST
Identifieur interne : 000777 ( Main/Exploration ); précédent : 000776; suivant : 000778FEVER IN THE IMMUNOCOMPROMISED HOST
Auteurs : Moss MendelsonSource :
- Emergency Medicine Clinics of North America [ 0733-8627 ] ; 1998.
English descriptors
- Teeft :
- Antibiotic, Antibiotic administration, Antibiotic therapy, Antimicrobial therapy, Asplenic, Asplenic patients, Bacteremia, Biopsy, Blood cultures, Cancer patient, Cancer patients, Cellular immunity, Chest radiograph, Clin, Common cause, Commonest cause, Cryptococcus neoformans, Defect, Dysfunction, Early infections, Emerg, Emergency department, Emergency medicine, Emergency physician, Empiric, Empiric therapy, Encapsulated organisms, Engl, Escherichia coli, Febrile, Febrile neutropenic patients, Fever, Fungal, Fungal infection, Fungal infections, Granulocyte, Granulocytopenia, Granulocytopenic cancer patients, Granulocytopenic patients, Helper cell, Helper lymphocyte, Higher risk, Host defenses, Immune, Immune defects, Immune function, Immune response, Immune system, Immune systems, Immunocomfromised host, Immunocompromised, Immunocompromised host, Immunocompromised hosts, Immunocompromised patient, Immunocompromised patients, Immunocompromised state, Immunosuppression, Immunosuppressive, Immunosuppressive drugs, Immunosuppressive therapy, Infection, Infectious complications, Infectious disease, Inflammatory response, Initial antibiotic treatment, Initial evaluation, Ivda patients, Liver disease, Long term, Lymphocyte, Macrophage, Mendelson, Mendelson table, Microbial diagnosis, Mortality rate, Necrotizing gingivitis, Neisseria meningitidis, Neutropenia, Neutropenic, Neutropenic patients, Neutrophil, Normal flora, Occult immunocompromise, Opportunistic infection, Oral antibiotics, Pathogen, Perirectal disease, Phagocytic cells, Physical examination, Physical findings, Potential pathogens, Prospective study, Regimen, Separate sites, Sepsis, Several days, Sickle cell disease, Sickle cell patients, Skin lesions, Staphylococcus aureus, System dysfunction, Thirdgeneration cephalosporin, Transplant, Transplant patients, Trauma, Viridans streptococci, Worse prognosis, Yeast candida.
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>Asplenic</term>
<term>Asplenic patients</term>
<term>Bacteremia</term>
<term>Biopsy</term>
<term>Blood cultures</term>
<term>Cancer patient</term>
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<term>Chest radiograph</term>
<term>Clin</term>
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<term>Commonest cause</term>
<term>Cryptococcus neoformans</term>
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<term>Emerg</term>
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<term>Granulocytopenia</term>
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<term>Granulocytopenic patients</term>
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<term>Immunosuppressive therapy</term>
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<term>Initial antibiotic treatment</term>
<term>Initial evaluation</term>
<term>Ivda patients</term>
<term>Liver disease</term>
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<term>Macrophage</term>
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<term>Mendelson table</term>
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<term>Mortality rate</term>
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<term>Neisseria meningitidis</term>
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<term>Neutropenic patients</term>
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<term>Normal flora</term>
<term>Occult immunocompromise</term>
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<term>Thirdgeneration cephalosporin</term>
<term>Transplant</term>
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<front><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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