Dibyendu Banerjee, Tanushree Banerjee and Vivek Vidyadhar Bhosale
Background and Aims: A febrile response is a common phenomenon in the ICU (Intensive Care Unit), often with complex and unknown origins. Fever is only one component of a febrile response and may or may not be an indication of severe infection.
Subjects and Methods: A febrile response caused by severe infection/s is often accompanied by neutropenia where the absolute neutrophil count goes below 500/mm3, or is predicted to go below 500/mm3 over the next 48 hours. Febrile neutropenia is generally an indication for an infection requiring the commencing of empirical antibiotics after taking appropriate cultures. However, severe infections may also occur in the absence of fever or neutropenia.
Conclusion: In cases of new fever, or fever of unknown origin, it is highly recommended that the latest IDSA (Infectious Disease Society of America) or SCCM (Society of Critical Care Medicine) guidelines be followed. Some recently launched antimicrobials not yet covered by the IDSA are discussed and maybe useful for treatment of drug resistant cases. It may also be useful to remember that fever is more often a friend than a foe.