This guideline, jointly prepared by the Infectious Disease Society of America and the Society of Critical Care Medicine, is available as free full text at the IDSA web site and represents the first revision in 10 years. Points of interest follow:
A new fever should trigger a clinical assessment rather than automatic orders for laboratory and radiographic testing.
Blood cultures, however, are indicated in all patients except those in whom the clinical assessment strongly indicates a non-infectious source of fever. Paired cultures rather than single cultures are recommended.
A clear approach to fever in patients with central venous lines is outlined.
Consider chest CT scanning in patients with negative plain chest x rays who are suspected of having pulmonary infections, particularly if immunocompromised.
Don’t forget nosocomial sinusitis.
“Catheter-associated bacteriuria or candiduria usually represents colonization,
is rarely symptomatic…” (Clinical documentation specialists, take note!).
Information on post operative fever and empiric antibiotic therapy is presented.