ICU · Infection / general

Fever in the ICU — Infectious or Not? The Workup & the Procalcitonin

Also known as Fever in the ICU · Pyrexia · ICU fever · Nosocomial infection · VAP · CRBSI · CAUTI · Drug fever · Central fever · Procalcitonin · Antipyresis

The fever in the ICU (the temp over 38.3) is the symptom, the not the diagnosis. The first question: the infectious or the non-infectious. The infectious (the nosocomial): the VAP, the CRBSI, the CAUTI, the SSI, the C. difficile, the sinusitis, the cholecystitis, the pressure ulcers, the primary. The non-infectious: the SIRS non-infection (the pancreatitis, the trauma, the burns, the post-op, the transfusion), the drug fever, the VTE, the malignancy, the central fever (the brain injury), the alcohol withdrawal, the adrenal insufficiency, the thyroid storm. The workup: the history and the exam (the lines, the wounds, the chest, the abdomen, the skin, the perianal, the sinuses); the cultures (the blood — the peripheral plus the EACH line lumen — the urine, the sputum, the wound); the imaging (the CXR, the CT); the markers (the CRP, the procalcitonin — the bacterial; the lactate). The management: the sepsis — the sepsis-6 within the 1 hour; the stable — the workup and the judicious the empirical antibiotics; the treat the cause; the paracetamol; the judicious the antipyresis (the fever protective in the sepsis); the active the cooling for the over 39 to 40 or the brain-injured (the TTM). The neutropenic — the empirical antibiotics the now.