TY - JOUR
T1 - Persistent fever in association with infective endocarditis
AU - Blumberg, Emily A.
AU - Robbins, Noah
AU - Adimora, Adaora
AU - Lowy, Franklin D.
N1 - Funding Information:
Received II February 1992; revised 30 June 1992. Grant support: E.AB. and AA were supported by a training grant from the National Institute of Allergy and Infectious Diseases (AI07183). * Present address: Division ofInfectious Disease, University of North Carolina, Chapel Hill, North Carolina. Reprints and correspondence: Dr. Emily A. Blumberg, Division of Infectious Diseases, Department of Medicine, M.S. 461, Hahnemann University, Broad and Vine Streets, Philadelphia, Pennsylvania 19102-1192.
PY - 1992/12
Y1 - 1992/12
N2 - Fever persisting despite adequate antimicrobial therapy for endocarditis can be an ominous sign. To evaluate the significance of persistent fever in this situation, we reviewed the records of patients at three hospital affiliates of Albert Einstein College of Medicine. Twenty-six patients with 27 episodes of endocarditis and fever lasting for?2 weeks despite appropriate antimicrobial therapy were identified and compared with a matched cohort of 26 patients with endocarditis but without prolonged fever. The median duration of fever in the former group was 35 days. Cardiac infection caused fever in 13 of these patients, seven of whom had myocardial abscesses. Additional causes of infection included drug treatment, nosocomial transmission of pathogens, and pulmonary emboli. Sixteen patients required cardiac surgery (seven on an emergent basis), whereas only two controls underwent such a procedure (P <.001). Twenty-two patients with persistent fever and five controls developed nosocomial complications (P <.001). Six patients with fever died, five from endocarditis-related complications. Thus persistent fever often indicates complicated endocarditis. We present an approach for the evaluation of the patients affected by this condition.
AB - Fever persisting despite adequate antimicrobial therapy for endocarditis can be an ominous sign. To evaluate the significance of persistent fever in this situation, we reviewed the records of patients at three hospital affiliates of Albert Einstein College of Medicine. Twenty-six patients with 27 episodes of endocarditis and fever lasting for?2 weeks despite appropriate antimicrobial therapy were identified and compared with a matched cohort of 26 patients with endocarditis but without prolonged fever. The median duration of fever in the former group was 35 days. Cardiac infection caused fever in 13 of these patients, seven of whom had myocardial abscesses. Additional causes of infection included drug treatment, nosocomial transmission of pathogens, and pulmonary emboli. Sixteen patients required cardiac surgery (seven on an emergent basis), whereas only two controls underwent such a procedure (P <.001). Twenty-two patients with persistent fever and five controls developed nosocomial complications (P <.001). Six patients with fever died, five from endocarditis-related complications. Thus persistent fever often indicates complicated endocarditis. We present an approach for the evaluation of the patients affected by this condition.
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U2 - 10.1093/clind/15.6.983
DO - 10.1093/clind/15.6.983
M3 - Article
C2 - 1457671
AN - SCOPUS:0026574827
SN - 1058-4838
VL - 15
SP - 983
EP - 990
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 6
ER -