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fever in icu

Z X Ren, C L Liu, Q Zhang, F Xu, Y N Zheng, X J Li, J Yang
RATIONALE: Necrotizing fasciitis (NF) is a life-threatening situation that is rare in children, especially infants, and early diagnosis is challenging. Timely identification and broad-spectrum antibiotic and supportive treatment before surgical debridement are very important for survival and may reduce scar formation. PATIENT CONCERNS: A previously healthy 4-month-old infant was admitted to our pediatric intensive care unit (PICU) with a history of fever and cough for 5 days and extreme swelling of the scrotum for one day...
March 2018: Medicine (Baltimore)
Haili Luo, Shaohong Wang, Tongmei Yuan, Jingtao Liu, Ling Yao, Xianguo Pan, Xuemei Long, Juncheng Wu, Feng Shen
BACKGROUND: More and more cases of human infections with avian influenza A H7N9 have been reported since it was first mentioned in 2013 in China, but concurrence of influenza A H7N9 with Mycoplasma pneumoniae, however, has never been described. Here, we reported the case of a woman co-infected by influenza A H7N9 and Mycoplasma pneumoniae, whose treatment process was a little bit longer and a little bit complicated as well. CASE PRESENTATION: Our patient was an 80-year-old Chinese woman who presented with fever, cough, chest tightness, and shortness of breath...
March 15, 2018: Journal of Medical Case Reports
Prabahs Prasun Giri, Joydeb Roy, Agnisekhar Saha
Aim of the Study: Scrub typhus has been globally recognized as an emerging infectious disease contributing significantly to pyrexia of unknown origin (PUO) and a potential cause of multiorgan dysfunction syndrome (MODS). We studied the incidence of scrub typhus as a cause of pediatric intensive care unit (PICU) admission and MODS in our hospital and its clinical and laboratory characteristics to measure the incidence of MODS caused by scrub typhus. Materials and Methods: This study was done in a pediatric teaching hospital in Kolkata, India...
February 2018: Indian Journal of Critical Care Medicine
Natalie Yu Yi Ng, Hannah Hui En Ang, Jacqueline Chieh Ling Tan, Weng Hoe Ho, Win Sen Kuan, Mui Teng Chua
PURPOSE: We aim to determine whether the combination of regional tissue oxygen saturation (StO2 ) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. METHODS: We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate≥100 beats per minute; or white cell count <4...
February 27, 2018: American Journal of Emergency Medicine
Karen Trudel, Samara Zavalkoff, Nicholas Winters, Caroline Quach, Jacques Lacroix, Patricia S Fontela
BACKGROUND: Prolonged use of indwelling catheters is associated with hospital-acquired urinary tract infections (UTIs). Literature is scarce about the factors influencing urinary catheter removal and maintenance in children. This study aims to describe the determinants of urinary catheter removal in pediatric intensive care unit (PICU) patients. METHODS: Cross-sectional survey of 171 physicians and nurses working at 2 tertiary PICUs in Montreal, Canada. We used focus groups and literature review to design the survey questions and 3 clinical scenarios...
March 5, 2018: American Journal of Infection Control
X Huang, L Weng, L Yi, M Li, Y Y Feng, Y Tian, J G Xia, Q Y Zhan, B Du
Objective: To investigate the clinical manifestations and prognostic factors of hospital death in connective tissue disease patients with acute respiratory failure caused by pneumocystis pneumonia (PCP) admitted to two medical intensive care units(MICU). Methods: A retrospective review was conducted for all connective tissue disease (CTD) patients with acute respiratory failure from PCP in MICU of 2 academic medical centers between 2010 and 2015. The patients were divided into survivors and non-survivors. Demographic and clinical data, including laboratory, radiological and microbiological findings, as well as therapy, clinical course, mortality and prognostic factors of hospital mortality were included in the analysis...
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Katharina Maria Busl
Infectious complications in the neurointensive care unit (neuro-ICU) are common, including pneumonia, urinary tract infection, bloodstream infection, and intracranial infection. The neuro-ICU population poses a specific challenge in the diagnosis of infections, because of the high incidence of fever in acutely brain-injured patients. Furthermore, susceptibility to infections is likely enhanced by brain-injury (induced immune modulation). This article reviews the concept of brain injury-induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus...
April 2018: Neurosurgery Clinics of North America
Laura Katharina Schenk, Hermann Pavenstädt, Philipp Kümpers
ANAMNESIS:  In winter, a 37-year old male patient consulted our outpatient clinic complaining about fever, malaise and headache. He had returned from vacation in Thailand 14 days earlier. EXAMINATIONS:  Clinical findings, laboratory examinations and apparative diagnostics revealed a pulmo-renal syndrom accompagnied by multi-organ failure. DIAGNOSIS:  Finally, we could confirm that our patient suffered from leptospirosis. TREATMENT:  The patient received a penicillin-based antibiotic treatment...
February 2018: Deutsche Medizinische Wochenschrift
Ashley Howard, Jaime Fergie
BACKGROUND: Murine typhus is a zoonotic infection caused by Rickettsia typhi that remains endemic in South Texas. In 2003, only 9 Texas counties reported murine typhus compared with 41 counties in 2013. METHODS: A retrospective study of children discharged with a confirmed diagnosis of murine typhus from Driscoll Children's Hospital between January 1998-September 2016. RESULTS: 213 children (113 female) 3 months through 19 years of age (mean, 11...
February 19, 2018: Pediatric Infectious Disease Journal
Amanda Su, Lindsay Lief, David Berlin, Zara Cooper, Daniel Ouyang, John Holmes, Renee Maciejewski, Paul K Maciejewski, Holly G Prigerson
CONTEXT: Deaths in the Intensive Care Unit (ICU) are increasingly common in the United States, yet little is known about patients' experiences at the end-of-life in the ICU. OBJECTIVES: The objective of this study was to determine nurse assessment of symptoms experienced, and care received by ICU patients in their final week, and their associations with nurse-perceived suffering and dignity. METHODS: From September 2015 to March 2017, nurses who cared for 200 ICU patients who died were interviewed about physical and psychosocial dimensions of patients' experiences...
February 16, 2018: Journal of Pain and Symptom Management
Eijiro Echizen, Kei Miyata, Ken Yamashita, Takeshi Mikami, Eichi Narimatsu, Nobuhiro Mikuni
BACKGROUND: Neurosurgical intervention for a patient with an extensive scalp burn is rare, but it might be associated with the high risk of surgical site infection. CASE DESCRIPTION: An 80-year-old man had a severe and extensive scalp burn. A chronic subdural hematoma (CSDH) was observed on a head CT for the assessment of bacteremia during treatment in the intensive care unit. To evaluate whether the CSDH might underlie his prolonged fever and sepsis pathology, we urgently evacuated the hematoma using one burr hole...
February 13, 2018: World Neurosurgery
Lenaïg Le Clech, Jean-Philippe Talarmin, Marie-Anne Couturier, Jean-Christophe Ianotto, Christophe Nicol, Ronan Le Calloch, Stéphanie Dos Santos, Pascal Hutin, Didier Tandé, Virginie Cogulet, Christian Berthou, Gaëlle Guillerm
INTRODUCTION: Immediate empirical antibiotic therapy is mandatory in febrile chemotherapy-induced neutropenia, but its optimal duration is unclear, especially in patients with fever of unknown origin (FUO). OBJECTIVES: The primary objective of this 20-month prospective observational study was to evaluate the feasibility and safety of short-term antibiotic treatment in afebrile or febrile patients exhibiting FUO, irrespective of their neutrophil count. The secondary objective was to describe the epidemiology of all episodes of febrile neutropenia...
February 16, 2018: Infectious Diseases
Lisa M Bebell, Joseph Ngonzi, Mark J Siedner, Winnie R Muyindike, Bosco M Bwana, Laura E Riley, Yap Boum, David R Bangsberg, Ingrid V Bassett
HIV infection may increase risk of postpartum infection and infection-related mortality. We hypothesized that postpartum infection incidence and attributable mortality in Mbarara, Uganda would be higher in HIV-infected than HIV-uninfected women. We performed a prospective cohort study of 4231 women presenting to a regional referral hospital in 2015 for delivery or postpartum care. All febrile or hypothermic women, and a subset of randomly selected normothermic women were followed during hospitalization and with 6-week postpartum phone interviews...
February 16, 2018: AIDS Care
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
Smita Nair, Amitabh Singh, Mamta Jajoo
This retrospective observational study aimed to find the clinical profile of hypernatremic dehydration in neonates. 49 neonates (3.4% of the total admitted newborns) developed hypernatremic dehydration. The major presenting complaints were fever (34.6%), poor feeding (42.8%), loose stools (40.8%) and lethargy (26.5%). The time needed for correction of hypernatremia was 38.6 (±15.1) hours. Exclusively breastfed neonates had lesser complication rates of hypernatremic dehydration.
February 9, 2018: Indian Pediatrics
Nele Van Damme, Els Clays, Sofie Verhaeghe, Ann Van Hecke, Dimitri Beeckman
BACKGROUND: Critically ill patients suffering from fecal incontinence have a major risk of developing incontinence-associated dermatitis (IAD). The presence of moisture and digestive enzymes (lipase, protease) negatively influences skin barrier function. Additional risk factors will make some patients even more vulnerable than others. In order to provide (cost) effective prevention, this specific patient population should be identified timely. OBJECTIVES: To identify independent risk factors for the development of IAD category 2 (skin loss) in critically ill patients with fecal incontinence...
February 2, 2018: International Journal of Nursing Studies
Shyam Sundar Krishnan, Pulak Nigam, Omar Bachh, Madabushi Chakravarthy Vasudevan
Hyperpyrexia is a rare and at times fatal condition seen in an Intensive Care Unit setup. We encountered a case of a 65-year-old patient with road traffic accident presenting with dorsal spine fracture at D10 level. He underwent decompression and fusion for the same. He developed hyperpyrexia of sudden onset on the 10th day of admission with no source of infection and adequate broad-spectrum antibiotic coverage with adequate thrombo-embolic prevention in place. The patient showed no response to antipyretic agents and other cooling methods...
January 2018: Indian Journal of Critical Care Medicine
Anish Gupta, Deven Juneja, Omender Singh, Suneel Kumar Garg, Varun Arora, Desh Deepak
Objective: Chikungunya is generally a mild disease, rarely requiring Intensive Care Unit (ICU) admission. However, certain populations may develop organ dysfunction necessitating ICU admission. The purpose of the study was to assess the clinical profile and course of chikungunya patients admitted to the ICU, and to ascertain factors linked with poor outcome. Methods: All patients with chikungunya admitted to ICU were included in the study. Admission Acute Physiology and Chronic Health Evaluation (APACHE) II score and sequential organ failure assessment (SOFA) score were calculated...
January 2018: Indian Journal of Critical Care Medicine
Wen Sun, Fen Liu, Shiliang Liu, Sara-Michelle Gratton, Darine El-Chaar, Shi Wu Wen, Dunjin Chen
OBJECTIVES: Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity. METHODS: Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Bishnu Rath Giri, Ram Hari Chapagain, Samana Sharma, Sandeep Shrestha, Sunita Ghimire, P Ravi Shankar
BACKGROUND: Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. METHODS: We examined the diagnoses of all children without trauma, admitted to Kanti Children's Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7...
February 5, 2018: BMC Pediatrics
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