Abstract：
:In the ICU, fever can be expected to accompany an extensive number of conditions of both infectious and noninfectious etiologies. It is crucial to identify the precise cause of fever, because certain conditions in either category may be life-threatening, whereas others require no treatment at all. It is important to rule out the most common infections that may be present based on historical and physical signs and symptoms and epidemiologic factors. The extent of evaluation should be based on the likelihood of the disease process being present and is highly variable for each individual patient. Therefore, "routine fever work-up" should not be advocated. If overt infection is not found upon initial evaluation, antibiotics should be withheld if possible. Alternatively, in the unstable patient, empiric therapy may be started, and if no infection is evident, it may be stopped within a reasonable time frame. In no case should prolonged antibiotics be given for presumed but unproven infection. Thorough knowledge of the more common infectious and noninfectious conditions, as well as the awareness of less frequent ones and their predisposing risk factors, is essential for adequate evaluation of the febrile ICU patient. Likewise, familiarity with the techniques used for diagnosis of these infections and their appropriate interpretation and limitations in specific instances is immensely helpful to the clinician providing appropriate care for the critically ill patient.
journal_name
Infect Dis Clin North Amjournal_title
Infectious disease clinics of North Americaauthors
Cunha BA,Shea KWdoi
10.1016/s0891-5520(05)70294-4subject
Has Abstractpub_date
1996-03-01 00:00:00pages
185-209issue
1eissn
0891-5520issn
1557-9824pii
S0891-5520(05)70294-4journal_volume
10pub_type
杂志文章,评审abstract：:The diagnostic approach to the compromised host with CNS infection depends on an analysis of the patient's clinical manifestations of CNS disease, the acuteness or subacuteness of the clinical presentation, and an analysis of the type of immune defect compromising the patient's host defenses. Most patients with CNS in...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70160-4
更新日期：2001-06-01 00:00:00
abstract：:An ever-increasing population of immunocompromised individuals, including not only the burgeoning AIDS population but also those patients whose host defenses have been damaged by a wide variety of diseases and their therapies, requires prophylaxis against infectious diseases. Existing vaccines can provide some benefit...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：:At the close of the 19th century, the germ theory had generated a new understanding of the causes of acute infectious diseases and revealed new directions for study. This understanding contributed to the greatest improvements in health in the history of medicine. At the end of the 20th century, the second stage of thi...
journal_title：Infectious disease clinics of North America
pub_type： 历史文章,杂志文章,评审
doi：10.1016/S0891-5520(03)00099-0
更新日期：2004-03-01 00:00:00
abstract：:Successful antimicrobial stewardship programs rely on engagement with hospital administrators. Antimicrobial stewards should understand the unique pressures and demands of hospital and health system administration and be familiar with key terminology and regulatory requirements. This article provides guidance on strat...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2019.10.003
更新日期：2020-03-01 00:00:00
abstract：:Oral lesions are easily visualized and often are signs of systemic diseases. Clinical diagnosis of viral and fungal infections can sometimes be confusing because many lesions will have similar clinical presentations. This article reviews the more common viral- and fungal-associated lesions found in the oral cavity in ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70110-0
更新日期：1999-12-01 00:00:00
abstract：:The penicillins continue to be important antibiotics for the treatment and prophylaxis of many infectious diseases. The emergence of resistant microorganism has led to the development of newer penicillin compounds that have extended spectrums of antimicrobial activity. Beta-lactamase production by many pathogenic bact...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:Staphylococcus aureus is a leading cause of bacteremia and endocarditis. Over the past several years, the frequency of S. aureus bacteremia (SAB) has increased dramatically. This increasing frequency, coupled with increasing rates of antibiotic resistance, has renewed interest in this serious, common infection. S. aur...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(01)00003-4
更新日期：2002-06-01 00:00:00
abstract：:Patients with hematologic malignancy or those who undergo hematopoietic stem cell transplantation experience variable degrees of immunosuppression, dependent on underlying disease, therapy received, time since transplant, and complications, such as graft-versus-host disease. Vaccination is an important strategy to mit...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2019.02.007
更新日期：2019-06-01 00:00:00
abstract：:This article establishes the pharmacokinetic-pharmacodynamic parameters that are important when considering the intracellular activity of antibiotics. Generally speaking, the main classes of antibiotics seem to share globally the same properties against extracellular and intracellular organisms. The specific cellular ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(03)00066-7
更新日期：2003-09-01 00:00:00
abstract：:Prevention is the best method for avoiding potentially serious complications of Lyme and other tick-borne diseases. In this article, we discuss preventative measures that can be used by individuals or communities. Among the topics discussed are personal protective measures, tick reduction, reservoir reduction, and vac...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2008.03.007
更新日期：2008-09-01 00:00:00
abstract：:This article familiarizes the clinician with the principles of bacterial susceptibility testing and reporting to facilitate communication with the clinical microbiology laboratory. The emergence of resistance in nearly all commonly isolated bacterial organisms has highlighted the need for ongoing dialogue between the ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2004.04.001
更新日期：2004-09-01 00:00:00
abstract：:Infection with HIV is a problem of growing magnitude among women and children in the United States. During 1991, AIDS will be among the five leading causes of death for women of childbearing age. Over 80% of children with HIV have acquired the infection vertically, and AIDS is now a leading cause of death of children ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-03-01 00:00:00
abstract：:Reactive arthritis is classified as a spondyloarthropathy. Current concepts of disease suggest an infectious trigger, followed by inflammatory arthritis. Several mechanisms have been proposed to explain the interaction of host susceptibility and microorganism. Diagnosis relies on a compatible clinical syndrome and mic...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2017.01.002
更新日期：2017-06-01 00:00:00
abstract：:Renal transplant recipients continue to have progressive kidney dysfunction and renal graft loss has been attributed to emerging opportunistic infections, specifically BK virus (BKV). BKV is postulated to be selected by the new potent immunosuppressive medications and to be an important factor in graft failure. The pr...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2013.02.002
更新日期：2013-06-01 00:00:00
abstract：:Recent decades have witnessed the emergence and spread of parasites resistant to standard drug therapies, particularly malaria. Chloroquine-resistant Plasmodium falciparum has now spread to most malarial areas, and resistance to other antimalarial drugs, including mefloquine and sulfadoxine-pyrimethamine, have become ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70400-1
更新日期：1997-12-01 00:00:00
abstract：:As the result of a formidable effort, the recent TB epidemic in the United States has abated; however, major questions remain as the risk of TB diminishes. Will we maintain an adequate public health effort not only to prevent another resurgence of TB but also to renew our pursuit of TB elimination? Do we have the will...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70200-2
更新日期：1998-09-01 00:00:00
abstract：:Fever of unknown origin is a topic that has enduring interest to physicians. Prolonged fevers of infectious etiology were of particular concern to the ancient physician. This overview of prolonged fevers in antiquity focuses on malaria and typhoid fever as the primary infectious causes. By studying texts from Mesopota...
journal_title：Infectious disease clinics of North America
pub_type： 历史文章,杂志文章
doi：10.1016/j.idc.2007.08.010
更新日期：2007-12-01 00:00:00
abstract：:Lyme disease affects the nervous system in about 10% to 15% of infected individuals, most commonly causing lymphocytic meningitis. Cranial neuropathies, particularly facial nerve palsy, also occur frequently. Figuring prominently in the European literature, but less emphasized in the United States, is painful radiculi...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2007.12.009
更新日期：2008-06-01 00:00:00
abstract：:Considering experience acquired in the past years, it seems as though physicians have reached a plateau in the frequency of peritonitis. A peritonitis rate of 1 every 2 patient years may be acceptable. Further reduction of this peritonitis rate will require inordinately large efforts on all fronts. One will have to co...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70171-9
更新日期：2001-09-01 00:00:00
abstract：:In this article, gynecologic conditions of increased importance in the HIV-infected woman are discussed. Women living with HIV may have an increase in menstrual disorders, lower genital tract neoplasias, gynecologic surgery, and sexually transmitted infections. The literature relevant to choosing a method of contracep...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2008.05.006
更新日期：2008-12-01 00:00:00
abstract：:It appears incontestable that there is a link between genital ulcer disease and HIV infection. On the one hand the natural history and response to therapy of syphilis, HSV-2, and chancroid are all modified by the immunosuppressive effects of HIV infection. On the other hand, HIV transmission is probably facilitated by...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1994-06-01 00:00:00
abstract：:Antiretroviral management of treatment-naive patients begins with the decision of when to start treatment. Current treatment guidelines suggest starting therapy in anyone with AIDS, HIV-related symptoms, or a CD4 cell count less than 200/mm3 regardless of symptoms. Starting treatment in asymptomatic patients with CD4 ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章
doi：10.1016/j.idc.2007.01.002
更新日期：2007-03-01 00:00:00
abstract：:In healthy adults and children in developed countries, most foodborne and water-borne infections are short-lived and resolve without specific treatment. In developing areas, these infections may produce acute mortality and chronic morbidity caused by developmental impairment. Immune-compromised hosts are at increased ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2013.05.006
更新日期：2013-09-01 00:00:00
abstract：:Although a small number of infections in total joint replacements are blood borne from distant sources, most infections appear to have been derived at operation. Strenuous attempts to reduce this risk by cleaning the air in the wound environment, coupled with prophylactic antibiotics, have reduced infection rates by a...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-09-01 00:00:00
abstract：:The combination of molecular pathogen diagnostics and the biomarker procalcitonin (PCT) are changing the use of antimicrobials in patients admitted to critical care units with severe community-acquired pneumonia, possible septic shock, or other clinical syndromes. An elevated serum PCT level is good supportive evidenc...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2017.05.003
更新日期：2017-09-01 00:00:00
abstract：:Pneumonia remains a major cause of morbidity and mortality in the immunocompromised host. The type and timing of immunosuppression will predispose the patient to infections with certain pathogens. This article discusses the types of immunosuppression and their infectious and noninfectious implications. Key points of t...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70210-5
更新日期：1998-09-01 00:00:00
abstract：:Injection drug use is the most common transmission route for hepatitis C. High rates of infection are observed among individuals on opioid agonist therapy. Although people who inject drugs carry the highest burden, few have initiated treatment. We present a comprehensive review of the evidence on the efficacy of HCV m...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2018.02.001
更新日期：2018-06-01 00:00:00
abstract：:Norovirus is the leading cause of acute gastroenteritis. In older adults, it is responsible for an estimated 3.7 million illnesses; 320,000 outpatient visits; 69,000 emergency department visits; 39,000 hospitalizations; and 960 deaths annually in the United States. Older adults are particularly at risk for severe outc...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2017.07.012
更新日期：2017-12-01 00:00:00
abstract：:Water serves as a major reservoir for the environmental mycobacteria. Many cases of cutaneous mycobacterial disease result from water exposure. The current theory of the pathogenesis of M. avium complex lung disease involves inhalation of organisms aerosolized from surface water. Disseminated M. avium disease in AIDS ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-09-01 00:00:00
abstract：:This article provides background information on the pharmacokinetics of antibacterial agents in patients who have normal and impaired renal function. Tables are provided to allow quick determination of appropriate dosages for varying degrees of renal failure. The use of serum levels; newer strategies for cefazolin, va...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2009.06.009
更新日期：2009-12-01 00:00:00
