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Fever, Adult, Emergency Medicine

Matthew L. Wong Reviewed 06/2017
 


Basics

Description

  • Fever is an elevation of core body temperature caused by an increase in the body's thermoregulatory set point.

  • Prostaglandin E2 (PGE2) synthesis in the anterior hypothalamus controls ...

Diagnosis

Signs and Symptoms

History

  • Chills, shivering, and rigors:

    • Rigors may suggest bacteremia

  • Weight loss:

    • Suggestive of neoplastic, chronic infectious, or endocrine disorders

  • Night sweats:

    • Suggestive of...

Treatment

Pre-Hospital

  • No specific field interventions required

  • Monitoring and IV access should be obtained in the field for unstable patients or patients with altered mental status.

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

  • Patients with unstable vital signs require ICU admission.

  • When identified, the underlying source of the fever usually determines the disposition.

  • Certain high-risk...

Pearls and Pitfalls

  • Screening lactates for sepsis.

  • Early, empiric, and broad-spectrum antibiotic coverage for all septic patients.

  • Consider all potential sources of infection.

  • Careful consideration for t...

Additional Reading

  • Cunha  BA. Fever of unknown origin: Focused diagnostic approach based on clinical clues from the history, physical examination, and laboratory tests. Infect Dis Clin North Am.  ...

Codes

ICD9

  • 780.60 Fever, unspecified

  • 780.61 Fever presenting with conditions classified elsewhere

ICD10

  • R50.2 Drug induced fever

  • R50.9 Fever, unspecified

  • R50.81 Fever presenting with conditions classified e...

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