[Fever in XXXX of a Service of Internal Medicine: prospective study in 204 cases].

@entity1 @entity295 @entity28 @entity6 @entity409 @entity793 @entity2259 @entity281 @entity1578 @entity358 @entity1282 @entity1030 @entity221 @entity580 @entity1851
OBJECTIVES: Fever in hospitalized @entity1 (FHP) is a difficult problem. We study clinical characteristics and predictive parameters of @entity281 , @entity295 and outcome. @entity1 AND METHODS: Prospective study of 204 @entity1 with @entity221 > 38 degrees C admitted in an Internal Medicine ward. In each @entity1 clinical evaluation, complete blood count (CBC) urinalysis (UA), @entity1851 ( @entity1851 ), chest X- ray (CXR), blood and urine cultures were performed. RESULTS: 115 @entity1 @entity281 (75.9% nosocomial, 7.4% @entity295 ), 35 had a non-infectious etiology and 54 an unknown cause. CBC and @entity1851 did not distinguish @entity281 , @entity2259 or @entity295 . In UA, positive nitrites, leukocytes and @entity793 were predictive of @entity281 . 18.6% of the @entity1 were diagnosed by CXR. 18% of urine cultures and 13% of blood cultures were positive. 71.6% received antibiotics (deemed unnecessary in 18%). Microbiological results modified 25% of initial treatments. Average hospital stay was 17 days; 16.7% died. @entity1030 , @entity221 duration, @entity1282 and urinary tract alterations predict @entity281 . @entity28 , @entity6 , @entity1578 , immunocompromised host, central vascular access, @entity221 duration and @entity580 predict @entity2259 . @entity295 is more prevalent in males, with @entity580 . @entity409 , @entity580 , severe @entity358 and @entity295 increase mortality. CONCLUSIONS: Clinical diagnosis of FHP is inaccurate. Infection is it s most frequent cause; UA, CXR, and blood and urine cultures are useful. FHP increases mortality and hospital stay. We have established predictable models of @entity281 , @entity2259 , @entity295 and mortality. However, its sensibility and specificity are low.
