The Internet Book of Critical Care Podcast IBCC Episode 90 - Fever
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Jul 18, 2020 This podcast episode discusses fever in the ICU, including different types of fever and challenges in defining it. It explores the value of fever curves and the use of anti-pyretic treatment. The appropriate use of broad spectrum antibiotics and source control is emphasized. The challenges of diagnosing drug rashes and laboratory abnormalities for different types of fever are also discussed.
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Fever Definition Is Variable
- Fever has no universally agreed temperature cutoff due to measurement variability.
- Infectious Disease Society suggests 38.3°C or 101°F for most, 38°C for vulnerable groups as practical guidelines.
Consider Fever Trends
- Consider fever trends, not just single readings, when evaluating temperature.
- Review multiple measurements over time to identify genuine fever patterns in ICU patients.
ICU Fever Differs from Community
- ICU-acquired fever likely indicates a new process after 2-3 days, distinct from community-acquired infection.
- Duration of ICU stay narrows the fever differential diagnosis significantly.