Fever/Antimicrobial Resistance Flashcards
(47 cards)
what degree is the “temp” of a fever?
> 101 or 38.3 degrees Celsius (some people say 100.4 or 100.8)
what is normal body temp? how many times does it peak during the day?
97-99.5 (36.0-37.4); peaks twice diurnally
what is hyperthermia?*
conditions or drugs that induce a BREAKDOWN of thermoregulatory systems, which results in elevated body temp
what is a fever?*
conditions that change the HYPOTHALAMIC SET POINT so that thermoregulatory systems create a higher body temp
fever pathophys: when __________ and __________ are stimulated by invading organisms, they put out ___________ ___________ that cause elevation in basal ______ __________
monocyte and macrophages; pyrogenic cytokines; body temperature
cytokines that affect ________ can be produced in ___________ situations: fever _____ _______ always = infection
temperature; noninfectious; does not
does degree of fever elevation correlate with severity of illness?
NO
children tend to have ________ fevers, compared to elderly who may ______ get a fever
higher; not
what type of medications may reduce febrile response?
anti-cytokine (esp interleukins)
what happens if fever is over 106?
can get irreversible brain damage
when should you treat a fever? what is the tx?
treat if over 104; antipyretics most helpful (acetaminophen or aspirin)
2nd line: warm water baths, ice packs
when would you treat fever at a lower temp (less than 104)?
to improve comfort or if pt is hemodynamically unstable (temp inc HR)
how to define a classic fever of unknown origin
adults: an illness lasting more than 3 weeks with temps greater than 101
* dx has not been made despite a good eval (3 hospital days or 3 outpatient visits)
a diagnosis eventually can be made in ______- _____% of FUO cases
70-90%
how to define a nosocomial FUO
fever greater than 101 on multiple occasions in hospitalized pt; infection not incubating on admission; uncertain dx after 3 day eval (including 2 day culture incubation)
definition of neutropenic FUO
Fever ≥38.3°C (101°F) on multiple occasions
Absolute neutrophil count <500/μL
Uncertain diagnosis after 3-day evaluation, including 2-day microbiologic culture incubation
definition of HIV associated FUO
Fever ≥38.3°C (101°F) on multiple occasions
Confirmed diagnosis of HIV infection
Fever >1mo (outpatients) or >3 days (inpatients)
Uncertain diagnosis after 3-day evaluation, including 2-day microbiologic culture incubation
what is the most common cause of FUO?
infections (1/3)
what is the most common systemic bacterial cause of FUO?
TB
besides infections, what also causes 1/3 of FUOs? what accounts for 20% of cases? what % of FUOs remain undiagnosed?
neoplasms; Rheumatologic diseases account for 20%; 10% remain undiagnosed
which patients usually get neutropenic fever?
pts on cytotoxic chemotherapy tx
neutropenic fever: with absolute neutrophils <1000/ul, pts are at ___ ____ for infection, but _______ if below 500/ul
high risk; critical
HIV patients who have a FUO are usually infected with….
MAC- mycobacterium avium complex
usual cause of elderly patients’ FUO
UTI
