Critical Care Time 50. Fever in the ICU
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Jun 2, 2025 Dr. Luis Tatem, a triple-boarded physician in Internal Medicine, Infectious Diseases, and Critical Care, dives into the complexities of fever in ICU patients. He discusses diagnostic strategies for fevers, especially in travelers returning from low-income countries, emphasizing the need for thorough travel history. Engaging case studies on malaria, dengue, and typhoid illustrate the critical urgency in managing these tropical diseases. Tatem’s expertise highlights the importance of collaborative care and staying informed about regional infections for effective treatment.
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Fever Is Context-Dependent
- Fever definitions vary by patient, environment, and disease.
- Trust patients who report feeling feverish, but confirm with accurate measurements.
Tailor Fever Workup to Symptoms
- Perform focused infectious workups based on clinical symptoms and history.
- Avoid reflexively ordering tests; trust targeted exams and reassess if patients can communicate.
Lab Tests: CBC with Differential
- Always order CBC with differential for fever to detect bandemia and eosinophilia.
- Use procalcitonin to guide antibiotic cessation, not initiation.