Fever

Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients

Original Articles, Volume 18, Issue 3, Pages 137 – 204 (2019)

Background: The relationship between increase in body temperature, heart rate, and respiratory rate has only been studied in young, healthy subjects.

Aim: To show the changes in heart and respiratory rate associated with fever in acutely admitted medical patients.

Design: A prospective observational cohort study

Methods: Vital parameters from 4,493 patients were retrospectively extracted. Linear and multiple variable regression analysis was used to calculate the change in heart and temperature rate for every degree rise in temperature (i.e. ΔHR/°C and ΔRR/°C) in the entire study group and in those with low (<36.1°C), normal (36.1-38°C) and high (>38°C) body temperatures.

Results: The ΔHR/°C and ΔRR/°C was 7.2±0.4 beats per minute (bpm) and 1.4 ±0.1 (1.2 to 1.62) breaths per minute (bpm). Adjusting for age, oxygen saturation and mean blood pressure, the results were 6.4±0.4 (5.7 to 7.1) bpm and 1.2±0.1 (1.0 to 1.4) bpm. In low, normal and high body temperature the ΔHR/°C were 2.7±1.9, 6.9±1.9 and 7.4±0.9 bpm, respectively; for ΔRR/°C the values were -0.5±0.5, 1.5±0.5 and 2.3±0.3 bpm, respectively.

Conclusions: We only found a modest association between fever and changes in heart rate and respiratory rate.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients Read More

Fever, delirium and incontinence: not always a UTI

Case Reports, Volume 15, Issue 3, Pages 109 – 164 (2016)

Abstract

Unexplained fever and confusion is a common reason for emergency medical admission. When this occurs in the context of new urinary incontinence, a urinary tract infection may be considered to be the most likely cause. However it is also important to consider spinal pathology when this combination of symptoms arises. We present a case of a retropharygeal collection presenting in a patient with this combination of symptoms.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Fever, delirium and incontinence: not always a UTI Read More

Ambulatory Outpatient Management of patients with low risk febrile neutropaenia

Trainee Section, Volume 14, Issue 4, Pages 145 - 196 (2015)

Patients with febrile neutropenia are a heterogeneous group with only a minority developing significant medical complications. Scoring systems, such as the Multinational Association for Supportive Care in Cancer (MASCC) score, have been developed and validated to identify low risk patients. Caring for patients with low risk febrile neutropenia in an ambulatory setting is proven to be safe and effective. Benefits include admission avoidance, cost savings and reduced risk of nosocomial infections, as well as improved patient experience and satisfaction. Implementation of an ambulatory pathway for low risk febrile neutropenia provides an excellent opportunity for Acute Physicians and Oncologists to collaborate in delivering care for this group of patients.

Ambulatory Outpatient Management of patients with low risk febrile neutropaenia Read More

Maps and missing malaria – if in doubt request a blood film

Case Reports, Volume 12, Issue 1, Pages 1 - 64 (2013)

Abstract

The severe sequelae of infection from the conventionally termed ‘benign’ forms of malaria are being increasingly recognised, and delayed diagnosis and treatment lead to worse outcomes. The clinical picture can be non-specific and malaria epidemiology is constantly changing, presenting challenges for the acute clinician. The most critical step in the diagnosis of patients presenting in the UK is the clinician’s awareness of the disease and its key presenting features. We describe a case of Plasmodium vivax malaria in a young man who presented with fever and diarrhoea, who had never travelled to a recognised malaria-endemic area.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Maps and missing malaria – if in doubt request a blood film Read More

Fever in the returning traveller

Papers, Volume 5, Issue 2, Pages 41 - 80 (2006)

Abstract

Travel-related infections are becoming more common as travel abroad becomes easier. Whilst most imported infections will have recognisable features some of the more obscure will be less familiar to the clinician. A detailed travel history including all stopovers is vital as is a thorough examination. Falciparum malaria is a medical emergency and prompt treatment is essential. Emerging infections such as SARS and avian influenza provide new challenges in diagnosis for the admitting team.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Fever in the returning traveller Read More

Fever in the returned traveller

Original Articles, Volume 1 Issue 1, Pages 1 - 32 (2002)

Abstract

The diagnosis of fever in the returned traveller is an important challenge to the physician. An accurate travel history and knowledge of the incubation period of common diseases is required to assess the risk of infection with a specific infectious agent. Although many febrile illnesses are benign and self-limiting, failure to diagnose malaria and enteric fevers may have disastrous consequences. All patients returning with fever should have thick and thin blood films for malaria and blood cultures performed. Other haematological and biochemical tests are useful in identifying a group of patients in whom empirical anti-microbial therapy is indicated. Thought must be given to the isolation of patients and notification of certain suspected or proven diseases to the local Consultant for Communicable Disease Control. Preventative measures in those likely to travel again should be discussed.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Fever in the returned traveller Read More

Shopping Basket
Scroll to Top

Start typing and press enter to search

Start typing and press enter to search