Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “fever”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed1997

Chemotherapy-induced neutropenia and fever in patients with metastatic breast carcinoma receiving salvage chemotherapy.

BACKGROUND: Chemotherapy-induced neutropenia and associated fever and infection are the most common complications of systemic chemotherapy. In this retrospective analysis, the authors evaluated the incidence of neutropenic fever, infection, and mortality in relation to the level of neutropenia, performance status, course number of chemotherapy, bone marrow metastasis, and age among patients with metastatic breast carcinoma receiving salvage chemotherapy. METHODS: A total of 174 patients with previously treated metastatic breast carcinoma enrolled on 4 consecutive Phase II protocols were evaluated. RESULTS: Twenty-three percent of the patients had an episode of neutropenic fever (41 episodes among 40 patients). The incidence of neutropenic fever did not increase until the absolute neutrophil count (ANC) had decreased to less than 500/microL, and then fever incidence had a linear relationship with decreasing ANC (linear trend, P < 0.01). A source of infection was documented in 59% of the neutropenic fever episodes. The incidence of infection did not increase significantly until the ANC had decreased to less than 250/microL (P < 0.01). The risk of neutropenic fever and infection was also significantly higher when patients had poor performance status or were undergoing the initial courses of chemotherapy. Patients with bone marrow metastases also had a higher frequency of fever, infection, and death, but these differences were not statistically significant. CONCLUSIONS: For patients with metastatic breast carcinoma receiving salvage chemotherapy, the risk of fever increases with decreasing ANC, but the risk of infection does not increase significantly until ANC decreases to less than 250/microL. Poor performance status, initial courses of chemotherapy, and bone marrow metastases further increase the risk of fever, infection, and death.

Adult↗
PubMed1999

High fever after flexible bronchoscopy and bronchoalveolar lavage in noncritically ill immunocompetent children.

Flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) have been applied increasingly to the evaluation of pulmonary disease in children. Although several complications have been reported following FB and BAL, high fever after BAL in immunocompetent children has not previously been reported. To determine the frequency, clinical characteristics, and outcome of these complications in children who developed high fever post-BAL, we retrospectively reviewed all bronchoscopic procedures done on an outpatient basis between August 1995 and July 1997. We identified 78 immunocompetent noncritically ill children who had undergone FB and BAL as an outpatient procedure for evaluation of underlying pulmonary disease, of whom 13 (17%) developed temperature (T) higher than or equal to 39 degrees C (fever group). The 13 patients in the fever group had a median age of 10 (range, 4-48) months and a reported T of 39.4 degrees C (39.1-40.6 degrees C) occurring 7.5 (4-12) hr after BAL. To determine if there were differences in clinical or BAL fluid (BALF) characteristics, we compared each child in the fever group to two children in the nonfever group, based upon primary indications and age. There were no differences in demographic or clinical characteristics between the two groups. Lymphocyte concentrations in BALF were significantly reduced in the fever group (P = 0.03). An abnormal BALF cell differential (defined as one or more of the following: neutrophils >10%, lymphocytes >30%, or eosinophils >1%) was significantly more common in the fever group (P = 0.008, odds ratio 3.6). We conclude that high fever is a frequent adverse event following BAL in noncritically ill immunocompetent children with underlying pulmonary disease. Pre-BAL clinical characteristics are not associated with development of high fever. However, the finding of an abnormal BALF cell differential is strongly associated with development of high fever post-BAL.

Bronchoalveolar Lavage↗
PubMed2007

Maternal flu or fever, medication use, and neural tube defects: a population-based case-control study in Northern China.

BACKGROUND: Maternal exposure to flu or fever has been associated with increased risk for neural tube defects (NTDs); however, few studies have considered the effects of medications on the effects of flu or fever. We evaluated the effect of maternal flu or fever, medication use (antibiotics, antipyretics), and their joint effect on NTDs. METHODS: Data came from an ongoing population-based case-control study of infants with external malformations in northern China. The case group included 363 infants with NTDs identified between January 2003 and June 2005. Controls were 523 newborn infants without identified congenital anomalies matched by county, sex, maternal ethnic group, and the closest date of conception for infants with any major external malformation. Data were collected by a trained health worker through face-to-face interviews after delivery. RESULTS: NTD risks were significantly associated with maternal flu or fever (adjusted odds ratio [AOR] = 3.93, 95% CI: 2.48-6.23) and antipyretic use (AOR = 4.86, 95% CI: 1.33-17.78), but not with antibiotic use (AOR = 1.75, 95% CI: 0.91-3.38) after adjusting for potential confounders. NTD risk associated with maternal antipyretic use was markedly higher for anencephaly (AOR = 7.03, 95% CI: 1.70-29.04) than for spina bifida (AOR = 3.98, 95% CI: 0.95-16.74). Mothers with flu or fever who were also using antipyretics showed a markedly higher AOR for anencephaly (14.75 vs. 4.52), spina bifida (16.30 vs. 3.85), and all NTDs combined (13.91 vs. 4.04) than mothers with flu or fever who were not using antipyretics. Maternal antibiotics did not markedly change the effects of flu or fever on anencephaly (4.17 vs. 4.83), spina bifida (5.08 vs. 4.21), and all NTDs combined (5.05 vs. 4.29). CONCLUSIONS: Maternal flu or fever and antipyretic use during the periconceptional period increases the risk for NTDs. Maternal exposure to antipyretics together with flu or fever results in a markedly higher risk of NTDs than exposure to flu or fever alone.

Abnormalities, Drug-Induced↗
PubMed1978

Factitious and fraudulent fever.

The task of elucidating the etiology of fever of undertermined origin remains a major undertaking. Factitious fever is uncommonly considered of major importance in the differential diagnosis of fever of undetermined origin although it is a readily identifiable, syndrome and one that is easily excluded one it has been considered. Early identification may reduce the necessity for prlonged, expensive and potentially hazardous hospitalizations for such patients. A retrospective study identified 2.2 per cent (11 of 506) of all patients whose fever on their charts was coded as fever of undetermined origin as having factitious fever. These patients either created factitious fever by manipulation of the thermometer or fraudulent fever by self-induced means. A review of the literature yielded an additional 70 cases in which fever was either the sole factitious sign or part of a larger, more complex factitious illness. Patients were typically young, female and often associated with the medical profession. Patients with factitious fever differ from those with the stereotyped Munchausen's syndrome and may be difficult to recognize. Signs leading to the recognition of this syndrome are emphasized. Since the nature of the psychiatric illness may vary from patient to patient, early discovery may facilitate psychiatric intervention as such patients may be more amenable to therapy.

Adolescent↗
PubMed1993

Molecular approaches for the treatment of hemorrhagic fever virus infections.

Viruses causing hemorrhagic fevers in man belong to the following virus groups: togavirus (Chikungunya), flavivirus (dengue, yellow fever, Kyasanur Forest disease, Omsk hemorrhagic fever), arenavirus (Argentinian hemorrhagic fever, Bolivian hemorrhagic fever, Lassa fever), filovirus (Ebola, Marburg), phlebovirus (Rift Valley fever), nairovirus (Crimian-Congo hemorrhagic fever) and hantavirus (hemorrhagic fever with renal syndrome, nephropathic epidemia). Hemorrhagic fever virus infections can be approached by different therapeutic strategies: (i) vaccination; (ii) administration of high-titered antibodies; and (iii) treatment with antiviral drugs. Depending on the molecular target of their interaction, antiviral agents could be classified as follows: IMP dehydrogenase inhibitors (i.e., ribavirin and its derivatives); OMP decarboxylase inhibitors (i.e., pyrazofurin); CTP synthetase inhibitors (i.e., cyclopentylcytosine and cyclopentenylcytosine); SAH hydrolase inhibitors (i.e., neplanocin A); polyanionic substances (i.e., sulfated polymers); interferon and immunomodulators.

Antiviral Agents↗
PubMed2003

Fever during anaesthesia.

Fever occurs when pyrogenic stimulation activates thermal control centres. Fever is common during the perioperative period, but rare during anaesthesia. Although only a limited number of studies are available to explain how anaesthesia affects fever, general anaesthesia seems to inhibit fever by decreasing the thermoregulatory-response thresholds to cold. Opioids also inhibit fever; however, the effect is slightly less than that of general anaesthesia. In contrast, epidural anaesthesia does not affect fever. This suggests that hyperthermia, which is often associated with epidural infusions during labour or in the post-operative period, may be a true fever caused by inflammatory activation. Accordingly, this fever might be diminished in patients who receive opioids for pain treatment. Post-operative fever is a normal thermoregulatory response usually of non-infectious aetiology. Fever may be important in the host defence mechanisms and should not be routinely treated lest the associated risks exceed the benefits.

Adjuvants, Anesthesia↗
PubMed2004

The evolution of the concept of 'fever' in the history of medicine: from pathological picture per se to clinical epiphenomenon (and vice versa).

The medical concept of 'fever' has undergone profound changes throughout the centuries. Galen of Pergamon considered fever as a systemic disease in itself, and it was only between 17th and 18th century that Hermann Boerhaave provided a more careful evaluation of the clinical phenomena related to fever. Apart from incorrect theories, a major obstacle to the development of a rational study of fever has been the lack of appropriate instruments of measurement; in effect, the clinical thermometer was not diffusely used in everyday medical practice until the mid 19th century. During this same period Ignaz Semmelweiss postulated that the pathological-anatomical changes recorded in women who had died because of puerperal fever represented a pathological reality clinically suggested by a whole cohort of symptoms and signs, among them fever. Even if enormous progress has been made in the 20th century with regard to fever, which is currently considered a clinical sign of many different diseases, its etiologic assessment remains a challenge. In fact, in 1961 the clinical picture of 'Fever of Unknown Origin' was officially defined. Since such diagnostic labelling is in effect a cover for our inability to discover the real causes of fever, in this case, paradoxically, fever goes back to being the whole pathological picture, just as it was retained to be many centuries ago.

Fever↗
PubMed1996

Reliability of subjective fever in triage of adult patients.

STUDY OBJECTIVE: To determine whether a historical complaint of fever is predictive of fever on emergency department triage. METHODS: We prospectively questioned 651 ambulatory adult patients in a military tertiary care emergency department as to whether they had fever before oral temperature was taken. Fever was defined as a temperature of 38 degrees C (100.4 degrees F) or greater. RESULTS: Sensitivity and specificity were 84% (95% confidence interval [CI], 71% to 95%) and 83% (95% CI, 80% to 86%), respectively. The prevalence of objective fever was 6.4%, yielding positive and negative predictive values of 25% (95% CI, 18% to 32%) and 99% (95% CI, 93% to 100%), respectively. Overall accuracy was 83% (95% CI, 80% to 86%). CONCLUSION: In this study, outpatients were fairly accurate in predicting fever. However, in an outpatient population with a low overall prevalence of objective fever, the predictive value of a complaint of fever representing an objective fever remained low. Therefore the complaint of subjective fever should be interpreted with caution when it is used to support a given diagnosis in an ambulatory care setting.

Adolescent↗
PubMed2000

Stress fever magnitude in laboratory-maintained California ground squirrels varies with season.

A previous study demonstrated that California ground squirrels (Spermophilus beecheyi) living in the natural environment had, independent of season, a significantly higher mean diurnal body temperature (T(b)) (39.6 degrees C) than either summer (37.5 degrees C) or winter (36.5 degrees C) laboratory maintained animals. Based upon the previous study it has been suggested that California ground squirrels living in the natural environment may have an elevated set-point for body temperature in a manner analogous to a stress fever response. The present study was conducted to determine if season and/or duration of laboratory open-field exposure influenced the magnitude of laboratory open-field stress fever. If stress fever was involved to some extent in the higher body temperature observed in animals from the natural environment, laboratory maintained animals should exhibit a lower magnitude stress fever during the summer months and a higher magnitude stress fever during the winter months. It was hypothesized that laboratory maintained animals would exhibit the same set-point for stress fever T(b) independent of season, and that the duration of open-field exposure would not influence the magnitude of stress fever. Adult California ground squirrels were acclimated to an ambient temperature of 20+/-1.0 degrees C under either LD 14:10 (summer) or LD 10:14 (winter) photoperiod conditions and individuals from both photoperiod conditions were exposed for periods of 2, 4, and 6 h to an open-field arena. An analysis of the data with a two-factor ANOVA demonstrated that season (photoperiod) significantly influenced the magnitude of the stress fever response (1.1+/-0.1 degrees C for summer animals; 2.1+/-0.2 degrees C for winter animals) while there was no significant influence of open-field exposure duration on stress fever magnitude. These results demonstrate that although the set-point for body temperature in unstressed laboratory maintained California ground squirrels varies with season, the set-point for body temperature in open-field stressed animals does not vary with season. These data lend support to the hypothesis that something like stress fever may play some role in the higher body temperature observed in California ground squirrels living in the natural environment.

Animals↗
PubMedDate not supplied

[Significance of postoperative fever after hip prosthesis implantation].

INTRODUCTION: Postoperative fever is a phenomenon well-known by every orthopedic surgeon, yet its etiological background and its relation to wound infections is still unclear. The number of publications related to this topics in general and in the special field of orthopedics is quite limited. METHOD: The incidence of postoperative fever in 177 patients who underwent total hip replacement was investigated; its nature and connections to possible bacterial wound infections are described. Moreover, the effectiveness of antibiotic therapy was also taken into consideration. RESULTS: In 39% of the sample, fever exceeding 38 degrees C was noted in the immediate postoperative period; in 87% of these cases, the fever was of unknown etiology, its background could not be specified by clinical tests and examinations. In four cases of the total 177 patients, microbiologically proven wound infection occurred during the period of hospital stay, but only three of these patients had fever. The results of patients treated with antibiotics because of fever did not differ significantly from those of patients who did not receive antibiotics. This was true from the aspect of both the disappearance of fever and the frequency of complications. CONCLUSION: The results emphasise that postoperative fever is only a minor predictive factor of wound infections; at the same time absence of fever does not mean absence of septic complications. In the case of immediate postoperative fever of unknown etiology and without clinical symptoms, it is inexpedient to start antibiotic treatment or to increase the prophylactic antibiotic dosage.

Adult↗
PubMed2005

Fever during post-acute rehabilitation in patients with brain injury.

OBJECTIVE: To investigate the incidence of fever during the post-acute rehabilitation phase in patients with brain injury. DESIGN: Prospective study. SUBJECTS: Seventy-four patients with brain injury. METHODS: Patients were evaluated for the presence of fever during the rehabilitation phase. Demographics, time since injury, acute hospital and rehabilitation stay, brain injury and clinical characteristics were recorded for all subjects. RESULTS: Of the study group, 36 patients (36/74; 48.6%) had at least 1 event qualified as fever. The most common cause of fever was urinary tract infection. There were only 2 patients considered as having central fever. Fever was significantly more frequent in patients with a greater number of neurological impairments, more severe neurological impairments and a lower level of independence. The rehabilitation stay was prolonged in patients with fever. The average length of rehabilitation stay was 62.5 days and 49.8 days in patients with or without fever, respectively. CONCLUSION: Infection is the most common cause of fever after brain injury and the incidence of central fever is low.

Acute Disease↗
PubMed2006

Fever after percutaneous nephrolithotomy: contributing factors.

BACKGROUND AND PURPOSE: The exact mechanism of fever and urosepsis after percutaneous procedures has not been established. This research studied the frequency of fever after percutaneous nephrolithotomy (PCNL) and the contributing factors. METHODS: In a cross-sectional study, from September 2003 to March 2004, all 217 patients with nephrolithiasis treated with PCNL at the Labbafinegad Specialized Urology Center were studied. Data were collected before, during, and after surgery. RESULTS: The frequency of fever after PCNL was 25.8% (n=56) although in 62.2% of the cases (n=135), no prophylactic antibiotics had been administered. The mean durations of hospitalization in patients with and without fever were 5.4+/-2.3 and 3.4+/-1.7 days, respectively (p=0.001). Significant correlations were observed between fever and female sex (p=0.005), positive urine culture (p=0.02), and nephrostomy tube insertion (p=0.041). Other variables did not prove to be significant. In logistic regression analysis, female sex and nephrostomy tube insertion were independently related to post-operative fever. CONCLUSION: Although a considerable proportion of our patients had not received prophylactic antibiotics, the rate of fever after PCNL was no higher than is reported in the literature. Use of only a short course of antibiotics before surgery for staghorn stones did not result in a higher rate of fever. Female sex created a higher risk for fever, probably because of the greater propensity to urinary tract infection. The significant relation of a nephrostomy tube to fever could be attributed to its role as a foreign body or to use in more complicated cases.

Adolescent↗
PubMedDate not supplied

Epidemiology of hemorrhagic fever viruses.

Twelve distinct viruses associated with hemorrhagic fever in humans are classified among four families: Arenaviridae, which includes Lassa, Junin, and Machupo viruses; Bunyaviridae, which includes Rift Valley fever, Crimean-Congo hemorrhagic fever, and Hantaan viruses; Filoviridae, which includes Marburg and Ebola viruses; and Flaviviridae, which includes yellow fever, dengue, Kyasanur Forest disease, and Omsk viruses. Most hemorrhagic fever viruses are zoonoses, with the possible exception of the four dengue viruses, which may continually circulate among humans. Hemorrhagic fever viruses are found in both temperate and tropical habitats and generally infect both sexes and all ages, although the age and sex of those infected are frequently influenced by the possibility of occupational exposure. Transmission to humans is frequently by bite of an infected tick or mosquito or via aerosol from infected rodent hosts. Aerosol and nosocomial transmission are especially important with Lassa, Junin, Machupo, Crimean-Congo hemorrhagic fever, Marburg, and Ebola viruses. Seasonality of hemorrhagic fever among humans is influenced for the most part by the dynamics of infected arthropod or vertebrate hosts. Mammals, especially rodents, appear to be important natural hosts for many hemorrhagic fever viruses. The transmission cycle for each hemorrhagic fever virus is distinct and is dependent upon the characteristics of the primary vector species and the possibility for its contact with humans.

Animals↗
PubMed1992

Fever in general practice. I. Frequency and diagnoses.

Although fever is a common symptom, few studies have broadly addressed this as a clinical problem in general practice. The aims of this study were to determine the frequency of fever among general practice patients in two rural municipalities in Norway, the diagnoses (according to ICHPPC-2-def.) of conditions causing fever, and the receptionist's role in the management of these problems. All the general practitioners and their receptionists within the study area participated. During 4 weeks throughout 1988 all individuals attending their general practitioner had their body temperature measured with an electronic thermometer (orally > or = 7 years, rectally < 7 years). Fever was defined as an oral body temperature > or = 37.5 degrees C (rectally > or = 38.0 degrees C in those < 7 years). All telephone applications, including telephone encounters for fever, were recorded. Fever was detected in 80 (5%) of a total of 1610 direct encounters: 36% of those below 7 years of age (n = 70) were febrile. One-third of the total encounters for fever were telephone encounters (n = 36), of which 30% were managed by the receptionists. A wide range of diagnoses were made, most of which were associated with infectious diseases. The distribution of the diagnoses of primary care patients with fever is different from those admitted to hospital for fever of unknown origin. General practitioners and their receptionists should consider fever a diagnostic challenge, especially when the patient is handled over the telephone.

Adolescent↗
PubMed1989

Statistical analysis of fever interval data.

Periodic fever syndromes usually do not show a clear fixed periodicity, and hence cannot be described by the mean and the standard deviation of the interval length. In those cases statistical tools must be used. Fever interval data can be described as a random point process; the renewal density function and its Fourier transform can be used to uncover hidden periodicities. In this report the estimation and evaluation of the renewal density function are described. The data of three patients with periodic fever were investigated. In one of these patients, suffering from periodic fever originating at the level of the hypothalamus, a 30-day periodicity was observed. In a female patient with hyperimmunoglobulinaemia D and periodic fever, menstruation often coincided with or was preceded by a fever episode. In the third patient with a Familial Hibernian Fever-like syndrome, an irregular fever pattern and no periodicity were found. The computerized analysis of the fever intervals may be useful in assessing various periodic fever syndromes.

Adult↗
PubMed2005

Fever: a concept analysis.

AIM: The purpose of this paper is to critically analyse the current state of the science literature in order to develop an accurate conception of fever. RATIONALE: The measurement of body temperature and treatment of fever have long been considered to be within the domain of nursing practice. What body temperature constitutes 'fever', however, is often not clear from nursing protocols or the literature. METHODS: Literature for this concept analysis was obtained by computerized searches of PubMed, CINAHL and BIOSYS for the years 1980-2004. Additional sources were obtained after reviewing the bibliographies of the literature identified by the initial search. The Wilsonian method of concept analysis provided the framework for the analysis. FINDINGS: Fever has characteristically been recognized as a cardinal sign of illness and has traditionally had negative connotations for patient well-being. Substantive advances over the past 20 years in immunology and neurophysiology have expanded understanding of the process of fever. This new knowledge has shifted the perception of fever as part of the acute-phase response to one of an adaptive nature. This knowledge has yet to be fully translated into changes in the fever management practices of nurses. CONCLUSIONS: Consistent usage of terminology in relation to fever should lead to improved and evidence-based care for patients, and to fever management practices consistent with current research. It is important to use clear language about fever and hyperthermia in discussions and documentation between nurses and among disciplines. By creating clarity in our language, we may help to achieve praxis.

Anxiety↗
PubMed2004

Local fever illness classifications: implications for home management of malaria strategies.

BACKGROUND: The Ugandan Ministry of Health has adopted the WHO Home Based Fever Management strategy (HBM) to improve access to antimalarial drugs for prompt (<24 h) presumptive treatment of all fevers in children under 5 years. Village volunteers will distribute pre-packed antimalarials free of charge to caretakers of febrile children 2 months to 5 years ('Homapaks'). OBJECTIVE: To explore the local understanding and treatment practices for childhood fever illnesses and discuss implications for the HBM strategy. METHODS: Focus Group Discussions were held with child caretakers in three rural communities in Kasese district, West Uganda, and analysed for content in respect to local illness classifications and associated treatments for childhood fevers. RESULTS: Local understanding of fever illnesses and associated treatments was complex. Some fever illness classifications were more commonly mentioned, including 'Fever of Mosquito', 'Chest Problem', 'the Disease', 'Stomach Wounds' and 'Jerks', all of which could be biomedical malaria. Although caretakers refer to all these classifications as 'fever' treatment differed; some were seen as requiring urgent professional western treatment and others were considered severe but 'non-western' and would preferentially be treated with traditional remedies. CONCLUSIONS: The HBM strategy does not address local community understanding of 'fever' and its influence on treatment. While HBM improves drug access, Homapaks are likely to be used for only those fevers where 'western' treatment is perceived appropriate, implying continued delayed and under-treatment of potential malaria. Hence, HBM strategies also need to address local perceptions of febrile illness and adapt information and training material accordingly.

Acute Disease↗
PubMed2003

Isolation of a rickettsia related to Astrakhan fever rickettsia from a patient in Chad.

We isolated a novel spotted fever group rickettsia from a patient coming back from Chad with fever and a maculopapulous rash. In Africa, only six pathogenic spotted fever group rickettsiae have been identified, R. conorii, R. africae, R. akari, R. aeschlimannii, "R. mongolotimonae," and R. felis. Our isolate was identified by PCR amplification and sequencing of the 16S rRNA (16S rDNA), citrate synthase (gltA), and rOmpA (ompA) encoding genes. The 16S rDNA, gltA, and ompA sequences of the isolate were found to be 99.7, 99.6, and 99.5% identical with that of Astrakhan fever rickettsia, respectively. This rickettsia is endemic in the Caspian sea area and has also recently been identified in Kosovo. Using mouse serotyping, the currently accepted method for the identification of spotted fever group rickettsiae, the Chad isolate exhibited a specificity difference of 2 when compared to Astrakhan fever rickettsia and at least 4 when compared with other members of the R. conorii complex. The Chad isolate should be considered a variant of Astrakhan fever rickettsia. This is the first description of Astrakhan fever rickettsia outside Europe and the bacterium may be responsible for cases of spotted fever in Chad. Although Astrakhan fever rickettsia is transmitted by Rhipicephalus ticks in Europe, further studies are indicated to identify its vector in Africa where these ticks are also prevalent.

Adult↗