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new onset fever in icu

Maria Shoaib, Jacqueline J Kraus, Muhammad T Khan
Herpes simplex virus encephalitis (HSVE) is a medical emergency associated with high mortality and morbidity. Definitive diagnosis is established by history, clinical examination, neuroimaging studies, supportive electroencephalogram (EEG) findings, and cerebrospinal fluid (CSF) analysis. We report a case of HSVE presenting as a stroke mimic in a 76-year-old female with a history of atrial fibrillation on warfarin. She was admitted to our medical intensive care unit with intermittent fever, lethargy, and new onset left-sided hemiparesis...
January 15, 2018: Curēus
Ahmad Awan, Bisma Ahsan, Hasan Iftikhar, Akbar Khan, Fasil Tiruneh, Yididia Bekele, Ankit Mahajan, Ahmed A Awan
We present the case of a 31-year-old female with a past medical history of B-cell leukemia, on maintenance chemotherapy administered via centrally placed implantable catheter port, who presented to the emergency room with fever, chills, and generalized body pain of one day's duration. After initial workup, the patient was admitted to the intensive care unit and managed for severe sepsis. The patient was found to have a new-onset 3/6 holosystolic murmur at the left lower sternal border. Furthermore, she developed an episode of supraventricular tachycardia that responded to adenosine...
July 11, 2017: Curēus
Stefano Meletti, Giada Giovannini, Giuseppe d'Orsi, Lisa Toran, Giulia Monti, Rahul Guha, Andreas Kiryttopoulos, Maria Grazia Pascarella, Tommaso Martino, Haris Alexopoulos, Martha Spilioti, Jana Slonkova
New-onset refractory status epilepticus (NORSE) is a rare but challenging condition occurring in a previously healthy patient, often with no identifiable cause. We describe the electro-clinical features and outcomes in a group of patients with NORSE who all demonstrated a typical magnetic resonance imaging (MRI) sign characterized by bilateral lesions of the claustrum. The group includes 31 patients (12 personal and 19 previously published cases; 17 females; mean age of 25 years). Fever preceded status epilepticus (SE) in 28 patients, by a mean of 6 days...
2017: Frontiers in Neurology
Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( < 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Sreenivasa Rao Sudulagunta, Mahesh Babu Sodalagunta, Mona Sepehrar, Shiva Kumar Bangalore Raja, Aravinda Settikere Nataraju, Mounica Kumbhat, Deepak Sathyanarayana, Siddharth Gummadi, Hemanth Kumar Burra
Dengue fever is a mosquito-borne arthropod-borne viral (arboviral) tropical disease in humans affecting 50-528 million people worldwide. The acute abdominal complications of dengue fever are acute appendicitis, acute pancreatitis, acute acalculous cholecystitis and non-specific peritonitis. Acute pancreatitis with new onset diabetes in dengue shock syndrome (DSS) is very rarely reported. We describe a case of 30-year-old man admitted in intensive care unit and was diagnosed with DSS with RT-PCR, NS1 antigen and dengue IgM antibody being positive...
November 2016: Oxford Medical Case Reports
Carlos H Gómez-Quintero, Álvaro A Faccini-Martínez, Carlos A Botero-García, Marcela Lozano, Liliana Sánchez-Lerma, Jorge Miranda, Salim Mattar, Marylin Hidalgo
Spoted fever group (SFG) rickettsioses are actually considered as emerging and re-emerging zoonotic diseases, caused by pathogenic bacteria of the spotted fever group rickettsiae (SFGR). Recently, serologic studies in human and animals conducted in Colombian Orinoquia, showed a high seroprevalence against SFGR. In June 2015, a 50-year-old male was admitted to a hospital in Bogotá, Colombia, with two days of malaise and temperature of 39°C, associated to generalized rash 24h after the onset of fever. He referred a work visit and outdoor activities in rural area of the Department of Meta 15days prior the onset of symptoms...
May 2017: Journal of Infection and Public Health
Sandra H Hoeboer, Heleen M Oudemans-van Straaten, A B Johan Groeneveld
BACKGROUND: We studied the value of routine biochemical variables albumin, C-reactive protein (CRP) and lactate dehydrogenase (LDH) to improve prediction and monitoring of acute respiratory distress syndrome (ARDS) severity in the intensive care unit. METHODS: In 101 critically ill patients, with or at risk for ARDS after new onset fever, data were collected on days (D) 0, 1, 2, and 7 after inclusion. ARDS was defined by the Berlin definition and lung injury score (LIS)...
2015: BMC Pulmonary Medicine
Sandra H Hoeboer, Heleen M Oudemans-van Straaten, A B Johan Groeneveld
BACKGROUND: We studied the value of routine biochemical variables albumin, C-reactive protein (CRP) and lactate dehydrogenase (LDH) to improve prediction and monitoring of acute respiratory distress syndrome (ARDS) severity in the intensive care unit. METHODS: In 101 critically ill patients, with or at risk for ARDS after new onset fever, data were collected on days (D) 0, 1, 2, and 7 after inclusion. ARDS was defined by the Berlin definition and lung injury score (LIS)...
December 2015: BMC Pulmonary Medicine
Simone Vigneri, Savino Spadaro, Ilaria Farinelli, Riccardo Ragazzi, Carlo A Volta, Jay G Capone, Elisabetta Sette, Valeria Tugnoli
A 69-year-old white man was admitted because of a clinical history of persistent cough and fever. Chest x-rays showed bilateral lung infiltrates with air bronchograms, whereas the urine antigen test resulted positive for Legionella pneumophila. The next day, he was transferred to the intensive care unit and intubated because of severe renal and respiratory distress. Neurological examination revealed distal weakness and loss of deep tendon reflexes in lower extremities. Nerve conduction studies displayed severe demyelinating sensorimotor polyneuropathy, and plasmapheresis was therefore applied with mild improvement...
December 2014: Journal of Clinical Neuromuscular Disease
T Coman, G Troché, O Semoun, B Pangon, F Mignon, G Jacq, S Merceron, N Abbosh, V Laurent, P Guezennec, M Henry-Lagarrigue, L Revault-d'Allonnes, H Ben-Mokhtar, J Audibert, F Bruneel, M Resche-Rigon, J-P Bedos, S Legriel
OBJECTIVES: We wanted to assess the diagnostic accuracy of urinary dipstick testing in excluding catheter-associated urinary tract infection (CAUTI) in intensive care unit (ICU) patients with fever or hypothermia. METHODS: This was a prospective observational cohort study in a medical-surgical ICU. Patients with new-onset fever >38.3 °C or hypothermia <36 °C at least 48 h after urinary catheter insertion were included over a 2-year period. At each episode, a urinary dipstick test and a urine culture were performed as the criterion standard...
August 2014: Infection
Pradeep Pankajakshan Nair, Vaibhav Wadwekar, Aditya Murgai, Sunil K Narayan
New onset refractory status epilepticus (NORSE) is a neurological emergency and difficult to treat condition. We report a case of involuntary movements resulting from thiopentone sodium infusion during the management of refractory status epilepticus. A young woman was admitted with fever and NORSE in the neurology intensive care unit. In addition to supportive measures, she was treated with intravenous lorazepam, phenytoin sodium, sodium valproate, midazolam and thiopentone sodium. While on thiopentone sodium, she developed involuntary twitches involving her upper limbs and face with EEG showing no evidence of ongoing status epilepticus...
2014: BMJ Case Reports
Hyun Ah Kim, Miri Hyun, Seong-Yeol Ryu
Rhodotorula species live in the environment, but can also colonize human epithelium, as well as respiratory, and gastrointestinal tracts. Reports of infection, especially in the past 2 decades, have noted increasing numbers of Rhodotorula infections, particularly in immunocompromised hosts, leading it to be considered emerging opportunistic pathogen. The major risk factors for infection were prolonged use of central venous catheters in patients with hematological and solid malignancies who are taking corticosteroids or cytotoxic drugs...
September 2013: Infection & Chemotherapy
Sandra H Hoeboer, A B Johan Groeneveld
OBJECTIVE: Although absolute values for C-reactive protein (CRP) and procalcitonin (PCT) are well known to predict sepsis in the critically ill, it remains unclear how changes in CRP and PCT compare in predicting evolution of: infectious disease, invasiveness and severity (e.g. development of septic shock, organ failure and non-survival) in response to treatment. The current study attempts to clarify these aspects. METHODS: In 72 critically ill patients with new onset fever, CRP and PCT were measured on Day 0, 1, 2 and 7 after inclusion, and clinical courses were documented over a week with follow up to Day 28...
2013: PloS One
Thanhtaik Kyaw, Rong Ji
SESSION TYPE: Infectious Disease Student/Resident Case Report Posters IIPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Infections with K. pneumoniae are usually hospital-acquired and occur primarily in patients with diminished resistance. Underlying diabetes was significantly more common with community-acquired infection. Compared with K. pneumoniae isolated from patients with primary bacteremia, abscess-forming organisms have a virulent hypermucoviscosity phenotype and may be associated with metastatic infection...
October 1, 2012: Chest
Tanya Bautovich, Andrew Numa
OBJECTIVE: The role of neuroimaging in children presenting with new-onset seizure is poorly defined. This study evaluates the incidence of abnormal CT findings in children admitted to the paediatric intensive care unit (PICU) with new-onset seizure and examines potential clinical variables associated with abnormal head CT findings. METHODS: A retrospective analysis of 89 previously asymptomatic children admitted to Sydney Children's Hospital (Sydney, Australia) PICU between November 2005 and September 2009 with new-onset seizure was undertaken...
June 2012: Emergency Medicine Australasia: EMA
S Lemmen, K Lewalter
Fever is common in patients in intensive care units. Sources of fever can be infectious or non-infectious. The most common sources of infectious fever include ventilator-associated pneumonia, intravascular catheter-related infections, infection with Clostridium difficile or sinusitis. Typical examples of non-infectious fever include thromboembolic events, myocardial infarction, autoimmune disease, withdrawal symptoms or a drug-fever. Every new onset of fever prompts diagnostic decisions, treatment with antipyretics should be discussed critically...
May 2012: Deutsche Medizinische Wochenschrift
Sandra H Hoeboer, Erna Alberts, Ingrid van den Hul, Annelies N Tacx, Yvette J Debets-Ossenkopp, A B Johan Groeneveld
OBJECTIVES: Fever suggests the presence of microbial infection in critically ill patients. The aim was to compare the role of old and new biomarkers in predicting absence or presence of microbial infection, its invasiveness and severity in critically ill patients with new onset fever. METHODS: We prospectively studied 101 patients in the intensive care unit with new onset fever (>38.3 °C). Routine infection parameters, lactate, procalcitonin (PCT), midregional pro-adrenomedullin (MR proADM), midregional pro-atrial natriuretic peptide (MR proANP) and copeptin (COP) were measured daily for three days after inclusion...
May 2012: Journal of Infection
A Rodríguez, L Alvarez-Rocha, J M Sirvent, R Zaragoza, M Nieto, A Arenzana, P Luque, L Socías, M Martín, D Navarro, J Camarena, L Lorente, S Trefler, L Vidaur, J Solé-Violán, F Barcenilla, A Pobo, J Vallés, C Ferri, I Martín-Loeches, E Díaz, D López, M J López-Pueyo, F Gordo, F del Nogal, A Marqués, S Tormo, M P Fuset, F Pérez, J Bonastre, B Suberviola, E Navas, C León
The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be obtained as soon as possible, with the immediate start of empirical antiviral treatment. Molecular methods based on nucleic acid amplification techniques (RT-PCR) are the gold standard for the diagnosis of influenza A/H1N1...
March 2012: Medicina Intensiva
Li Sha, Ru-nan Zhu, Ling Cao, Yi Yuan, Ying Li, Dong Qu, Fang Wang, Yu Sun, Jie Deng, Lin-qing Zhao, Yuan Qian, Xiao-xu Ren, Jun-bao Du
OBJECTIVE: The novel influenza A (H1N1) virus firstly detected in April 2009 in Mexico rapidly spread to many countries including the United States and Canada where humans were infected with the H1N1 virus and deaths were reported. The pandemic virus strain had never been detected in specimen of human beings and swine. It was so highly contagious and widely spread that threatened life of humans globally. This study aimed to analyze clinical data of hospitalized children patients with 2009 novel H1N1 influenza A virus infection confirmed by etiologic tests, and compared with that of seasonal influenza A...
July 2011: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Angeliki M Tsimogianni, Aikaterini Flevari, Alex Betrosian, Despoina Sarridou, Dimitris Bakos, Ilias Andrianakis, Emmanouil Douzinas
INTRODUCTION: A case of fasciitis and septic shock complicating retrocecal appendicitis is presented. CASE REPORT: A 52-year-old man presented to the Emergency Department with lumbar pain, fever of recent onset and subsequently developed septic shock attributed to fasciitis of abdominal, flank and groin region. On intensive care unit, he was managed with broad-spectrum intravenous antibiotics and surgical debridement. An abdominal computed tomography scan confirmed the findings of fasciitis and was negative for intra-abdominal pathology...
February 2012: American Journal of the Medical Sciences
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