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Febrile patient in icu

Falguni Parikh
Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally these patients can go on to develop a stormy course with multiorgan dysfunction requiring intensive care unit admission associated with high morbidity and mortality...
February 2016: Journal of the Association of Physicians of India
Khuen F Ng, Kah K Tan, Zhi H Sam, Grace Ss Ting, Wan Y Gan
AIM: The aim of this study is to describe epidemiology, clinical features, laboratory data and severity of respiratory syncytial virus (RSV) acute lower respiratory infection (ALRI) in Malaysian children and to determine risk factors associated with prolonged hospital stay, paediatric intensive care unit (PICU) admission and mortality. METHODS: Retrospective data on demographics, clinical presentation, outcomes and laboratory findings of 450 children admitted into Tuanku Jaafar Hospital in Seremban, Malaysia from 2008 to 2013 with documented diagnosis of RSV ALRI were collected and analysed...
October 5, 2016: Journal of Paediatrics and Child Health
Heidrun Boztug, Nora Mühlegger, Ulrike Pötschger, Andishe Attarbaschi, Christina Peters, Georg Mann, Michael Dworzak
Intensive chemotherapy directed against acute myeloid leukemia of childhood is followed by profound neutropenia and high risk for bacterial and fungal infections, including viridans group streptococci as a common cause for gram-positive septicemia. Few retrospective studies have shown the efficacy of various antibiotic prophylactic regimens in children. We retrospectively studied 50 pediatric patients treated on the AML-BFM 2004 protocol between 2005 and 2015 at St. Anna Children's Hospital and assessed the effect of antibiotic prophylaxis on the frequency of febrile neutropenia and bacterial sepsis...
October 4, 2016: Annals of Hematology
Fernando Rosso, Sara Vanegas, Sarita Rodríguez, Robinson Pacheco
INTRODUCTION: Little is known about the prevalence and clinical course of dengue infection in elderly patients living in endemic areas; it is presumed that there is a lower prevalence but higher severity, complications and mortality.  OBJECTIVE: To describe the prevalence and clinical course of dengue infection in elderly patients who were admitted to a referral care center for infectious diseases in an endemic region.  MATERIALS AND METHODS: We conducted an observational and descriptive study between 2011 and 2014, using a cohort of elderly patients with serological diagnosis of dengue...
2016: Biomédica: Revista del Instituto Nacional de Salud
Niteen D Karnik, Anish V Gupta
Acute respiratory distress syndrome (ARDS) is a fulminant clinical disorder of varied etiology, characterized by diffuse lung injury and severe hypoxemia. It is a leading cause of ICU admission and the associated high mortality has sparked a lot of research on etiology, outcome, scoring systems, mortality predictors, biomarkers including inflammatory cytokines and even genomics in ARDS. The previously used AECC (American European Consensus Conference) definition (1994) of ARDS was replaced by the recent Berlin definition (2012) so as to improve its validity and reliability...
November 2015: Journal of the Association of Physicians of India
Ching-Chia Kuo, Yu-Shin Lee, Ming-Ru Lin, Shao-Hsuan Hsia, Chih-Jung Chen, Cheng-Hsun Chiu, Mao-Sheng Hwang, Yhu-Chering Huang
BACKGROUND/PURPOSE: Kawasaki disease (KD) is a febrile systemic vasculitis, and some patients may develop serious complications requiring intensive care. We aim to ascertain the clinical presentations and outcomes of these patients. METHODS: From October 2004 to October 2014, children with KD who had stayed in the pediatric intensive care unit (ICU) for acute stage treatment were defined as case patients; for each case, three age/sex-matched patients with KD but without ICU stay, if identified, were selected as control patients...
July 29, 2016: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
R I Claassen, C Savelkoul, M A Schouten, D H T Tjan
Post-splenectomy sepsis is a serious condition with high mortality rates. We present a case of a 64-year-old patient with a medical history of splenectomy who was referred to the Emergency Department with a fever, shivers, and an altered mental state. The symptoms had started twelve hours before. Upon arrival in the hospital the patient was tachypnoeic, hypotensive and febrile. Blood cultures were taken and broad-spectrum antibiotics were started. He was directly admitted to the Intensive Care Unit with severe sepsis of unknown aetiology...
2016: Nederlands Tijdschrift Voor Geneeskunde
Esther M Ellis, Tyler M Sharp, Janice Pérez-Padilla, Liza González, B Katherine Poole-Smith, Emmaculate Lebo, Charlotte Baker, Mark J Delorey, Brenda Torres-Velasquez, Eduardo Ochoa, Brenda Rivera-Garcia, Hector Díaz-Pinto, Luis Clavell, Anabel Puig-Ramos, Gritta E Janka, Kay M Tomashek
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal disorder characterized by fever, pancytopenia, hepatosplenomegaly, and increased serum ferritin. HLH is being increasingly reported as a complication of dengue, a common tropical acute febrile illness. METHODOLOGY/PRINCIPAL FINDINGS: After a cluster of pediatric dengue-associated HLH patients was identified during the 2012-2013 dengue epidemic in Puerto Rico, active surveillance and a case-control investigation was conducted at four referral hospitals to determine the incidence of HLH in children and identify risk factors for HLH following dengue...
August 2016: PLoS Neglected Tropical Diseases
Luciana Teofili, Caterina Giovanna Valentini, Roberta Di Blasi, Nicoletta Orlando, Luana Fianchi, Gina Zini, Simona Sica, Valerio De Stefano, Livio Pagano
It is still under debate whether granulocyte transfusions (GTs) substantially increase survival in patients with febrile neutropenia. We retrospectively examined data relative to 96 patients with hematological malignancies receiving 491 GTs during 114 infectious episodes (IE). Patients were grouped according to the median doses of granulocytes transfused during the infectious episode (low-dose group: <1.5-x108 cells/Kg; standard-dose group: 1.5-3.0x108 cells/Kg and high-dose group: >3.0x108 cells/Kg)...
2016: PloS One
Nour Al Faqeer, Ola Mashni, Rawan Daoud, Asma Rumman, Esraa Hanoun, Lama Nazer
Studies have raised concern about the safety of generic compared with branded drugs. Febrile neutropenia (FN) resulting in hospital admission was compared between the branded docetaxel (Taxotere®, Sanofi) and two generic formulations (docetaxel Ebewe and docetaxel Hospira) in patients with breast cancer. This was a retrospective study that included patients with breast cancer who received docetaxel between January, 2012 and December, 2014. Patients who had an admission diagnosis of FN and had received docetaxel within 14 days prior to admission were evaluated...
August 1, 2016: Journal of Clinical Pharmacology
Brian Appavu, Lisa Vanatta, John Condie, John F Kerrigan, Randa Jarrar
PURPOSE: We aimed to study whether ketogenic diet (KD) therapy leads to resolution of super-refractory status epilepticus in pediatric patients without significant harm. METHOD: A retrospective review was performed at Phoenix Children's Hospital on patients with super-refractory status epilepticus undergoing ketogenic diet therapy from 2011 to 2015. RESULTS: Ten children with super-refractory status epilepticus, ages 2-16 years, were identified...
October 2016: Seizure: the Journal of the British Epilepsy Association
Andreas Wieser, Thomas Löscher, Mirjam Schunk, Michael Seilmaier, Lukas Balzer, Gabriele Margos, Ulrich von Both, Thomas Schulzki, Sabine Kopf, Martin Hoch, Andreas Sing, Volker Fingerle
Introduction | Relapsing fevers, transmitted by arthropods, are rarely encountered in Germany, thus they are often not considered as differential diagnosis in febrile patients. In the last months, more than fourty cases of louse-borne relapsing fever were diagnosed in asylum seekers in Germany. Some of the patients had to be admitted to intensive care units, one patient died despite therapy. Pathogen, disease and diagnosis | The causative agents are spirochetes of the genus borrelia, which can reach high densities in patient blood...
July 2016: Deutsche Medizinische Wochenschrift
Sahajal Dhooria, Inderpaul Singh Sehgal, Anshu Kumar Agrawal, Ritesh Agarwal, Ashutosh Nath Aggarwal, Digambar Behera
BACKGROUND AND AIMS: This study aims to evaluate the sleep quality, architecture, sleep-related quality of life, and sleep-disordered breathing (SDB) in acute respiratory distress syndrome (ARDS) survivors early after discharge. MATERIALS AND METHODS: In this prospective, observational study, consecutive patients with ARDS discharged from the Intensive Care Unit (ICU) underwent evaluation with Epworth sleepiness scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Functional Outcomes of Sleep Questionnaire (FOSQ), and overnight polysomnography...
June 2016: Indian Journal of Critical Care Medicine
Yuan Dongliu, Yang Guoliang, Xu Haocheng, Qing Shuaijia, Bing Li, Jia Yanglei
This study reports an outbreak of acute febrile respiratory illness caused by human adenovirus B [P14H11F14] in a military training center in China between May and June 2014. In total, 164 military personnel were affected, and two patients were admitted into the intensive care unit of the military regional central hospital. A HAdV-B [P14H11F14] virus was confirmed as the etiological pathogen of this acute outbreak of febrile respiratory illness based on clinical manifestations, epidemiological characteristics, specific molecular detection results, phylogenetic analysis, and serological assays...
September 2016: Archives of Virology
Jonathan Carter, Shannon Philp, King M Wan
BACKGROUND: Fast track surgery (FTS) programs minimise the stress response after surgery and allow for enhanced recovery. AIMS: To document the frequency and incidence of adverse events in patients enrolled on a FTS program and to investigate factors associated with shorter length of stay and readmission to hospital. METHODS: A seven-year updated surgical audit of patients undergoing laparotomy for suspected or confirmed malignancy on a FTS program...
June 21, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Remyasri Nair, Nithish M Bhandary, Ashton D D'Souza
AIMS: To investigate initial Sequential Organ Failure Assessment (SOFA) score of patients in Intensive Care Unit (ICU), who were diagnosed with infectious disease, as an indicator of multiple organ dysfunction and to examine if initial SOFA score is a better mortality predictor compared to Simplified Acute Physiology Score (SAPS). MATERIALS AND METHODS: Hospital-based study done in medical ICU, from June to September 2014 with a sample size of 48. Patients aged 18 years and above, diagnosed with infectious disease were included...
April 2016: Indian Journal of Critical Care Medicine
Joyce Cm Lam, Jie Yang Chai, Yi Ling Wong, Natalie Wh Tan, Christina Tt Ha, Mei Yoke Chan, Ah Moy Tan
INTRODUCTION: Treatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution. MATERIALS AND METHODS: Patients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols...
November 2015: Annals of the Academy of Medicine, Singapore
Mashael F Alqahtani, Craig M Smith, Scott L Weiss, Susan Dawson, Hantamalala Ralay Ranaivo, Mark S Wainwright
Elevated plasma concentrations of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), mid-regional pro-atrial natriuretic peptide (mrProANP), and adipocyte fatty-acid-binding proteins (A-FaBPs) have been investigated as biomarkers for sepsis or detection of acute neurological injuries in adults, but not children. We carried out a single-center, prospective observational study to determine if these measures could serve as biomarkers to identify children with sepsis. A secondary aim was to determine if these biomarkers could identify children with neurologic complications of sepsis...
2016: PloS One
Amy Lynn A Teleron, Brandon K Rose, David M Williams, Suzanne E Kemper, James E McJunkin
BACKGROUND: La Crosse viral encephalitis is well described in children, but to date, there are only 2 adult cases described in the literature. Despite the fact that pediatric infection can be life threatening and typically presents as a febrile meningoencephalitis often complicated by seizures and mental status changes, little is known about the presentation and course of adult infection. We report the largest case series of adult La Crosse encephalitis. METHODS: Inpatient data were reviewed between 2001 and 2012 to identify adults (≥18 years of age) with possible La Crosse encephalitis...
August 2016: American Journal of Medicine
Santosh Kumar Rathia, Jhuma Sankar, Devasenathipathy Kandasamy, Rakesh Lodha
Cerebral malaria is a well-known complication of Plasmodium falciparum malaria. Over recent years, however, Plasmodium vivax also has been reported to cause cerebral malaria with or without co-infection with P. falciparum Here, we report a boy aged 10 years presenting with acute febrile encephalopathy with raised intracranial pressure to the emergency, who was later diagnosed to have P. vivax malaria. His neurological status improved gradually during 6 weeks of pediatric intensive care unit stay. We report this case to highlight the unusual radiologic findings in the patient, such as multifocal hemorrhagic infarcts in the brainstem, bilateral thalami, frontal cortex and basal ganglia, which have not been reported with P...
August 2016: Journal of Tropical Pediatrics
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