The American journal of medicine
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To determine the frequency and to identify predictive factors of occult major illness in febrile intravenous drug users (IVDUs) presenting to an emergency room. ⋯ Clinical tests and physician assessments are unable to distinguish occult major illness from minor illness among febrile IVDUs at presentation. Occult major illness is best identified by blood culture. If patient follow-up is unreliable, then hospitalization of febrile IVDUs, while awaiting blood culture results, remains a wise policy.
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Acute respiratory failure necessitating intubation and mechanical ventilation in patients with acute severe asthma is relatively uncommon, and there are few data available regarding positive pressure ventilation in critically ill patients with asthma. We therefore decided to evaluate our experience with the use of mechanical ventilation for acute asthma and to critically review previous reports on this subject. ⋯ Although there appears to be a trend toward increased survival after mechanical ventilation for acute asthma, ventilation of critically ill asthmatic patients continues to be a potentially perilous venture associated with significant morbidity and mortality.