Emergency medicine clinics of North America
-
Emerg. Med. Clin. North Am. · Nov 2013
ReviewFever and signs of shock: the essential dangerous Fever.
A common cause of fever with signs of shock is sepsis. Sepsis describes the spectrum of illness caused by severe infection. The incidence of sepsis is increasing and mortality can be high. ⋯ Early treatment includes empirical antibiotics and resuscitation. The diverse physiology present in sepsis can make the resuscitation complex; many different types of hemodynamic monitoring may be necessary. Even with this complexity, an organized approach can improve patient outcomes.
-
Fever is one of the most common reasons for the emergency department presentation of immunocompromised patients. Their differential diagnosis can be broad and includes rare or unexpected pathogens. ⋯ This article reviews the diagnosis and management of fevers in patients immunocompromised by human immunodeficiency virus/AIDS, solid-organ and hematopoietic transplants, chemotherapy-induced neutropenia, and tumor necrosis factor-α inhibitors. Prompt recognition of the type of immunosuppression and delineation of possible causes of fever are critical for management of these complex patients.