Diagnosis and Management of Systemic Infections and Fever in Neurological Patients

James D. Richardson

doi:10.1055/s-2000-9430

Seminars in Neurology, Table of Contents

Semin Neurol 2000; Volume 20(Number 03): 387-392
DOI: 10.1055/s-2000-9430

Diagnosis and Management of Systemic Infections and Fever in Neurological Patients

James D. Richardson

Department of Medicine, Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana

Abstract

ABSTRACT

The hospital course of a patient with a neurological disorder may be complicated by the development of fever, urinary tract infection (UTI), bacteremia, pneumonia, diarrhea, pressure sores, or intravenous line infections. An approach to each of these is provided in this review as well as recommendations for empirical therapy of catheter-related UTIs, intravenous line infections, and aspiration pneumonia.

KEYWORD

urinary tract infection - pneumonia - intravenous line infections

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References

REFERENCES

1 Wolff S M. Biological effects of bacterial endotoxins in man. J Infect Dis . 1973; 733-758 (733-758 )
2 Smith J W, Urba W j, Curti B D. The toxic and hematologic effects of interleukin-1 alpha administered in a phase I trial to patients with advanced malignancies. J Clin Oncol . 1992; 10 1141-1152
3 Malcangi U, Moro M L, Carpi D, Ramello A. Urinary tract infection prevention in catheterized patients. Prevalence National Study: preliminary studies at the Pnerolo Hospital. Minerva Urol Nefrol . 1996; 48 43-46
4 Sobel J D, Kaye D. Urinary tract infections. In: Mandell Gl, Douglas RG Jr, Bennett JE, eds. Principles and Practice of Infectious Diseases 3rd ed. New York: Churchill Livingstone 1990: 582-611
5 Nicolle L E, Mayhew W J, Bryan L. Prospective randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized elderly women. Am J Med . 1987; 83 27-33
6 Beaujean D J, Blok H E, Vandenbroucke-Grauls C M, Weersink A J, Raymakers J A, Verhoef J. Surveillance of nosocomial infections in geriatric patients. J Hosp Infect . 1997; 36 275-284
7 Padoveze M C, Dantas S P, Reginato L, von Nowakonski A, deOliveira U M, Trabasso P. Relative frequency of nosocomial microorganisms at UNICAMP University Hospital from 1987 to 1994. Rev Inst Med Trop Sao Paulo . 1997; 39 333-336
8 Bregenzer T, Conen D, Sakmann P, Widmer A F. Is routine replacement of peripheral intravenous catheters necessary?. Arch Intern Med . 1998; 158 151-156
9 Cunha B A. Intravenous line infections. Crit Care Clin . 1998; 2 339-346
10 Richards M J, Edwards J R, Culver D H, Gaynes R P. Nosocomial infections in medical intensive care units in the United States: National Nosocomial Infections Surveillance System. Crit Care Med . 1999; 27 887-892
11 Weinstein M P, Towns M L, Quartey S M. The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin Infect Dis . 1997; 24 584-602
12 Ujiie H, Teshima H, Maeda T. Background and prognostic factors of fungemia in patients with hematological disease. J Jpn Assoc Infect Dis . 1998; 72 912-917
13 Leroy O, Bosquet C, Vandenbussche C. Community acquired pneumonia in the intensive care unit: epidemiological and prognosis data in older people. J Am Geriatr Soc . 1999; 47 539-556
14 Gopalakrishnan R, Hawley H B, Czachor J S, Markert R J, Bernstein J M. Stenotrophomonas maltophilia infection and colonization in the intensive care units of two community hospitals: a study of 143 patients. Heart Lung . 1999; 28 134-141
15 Ewig S, Torres A, El-Ebiary M. Bacterial colonization patterns in mechanically ventilated patients with traumatic and medical head injury: incidence, risk factors, and association with ventilator-associated pneumonia. Am J Respir Crit Care Med . 1999; 159 188-198
16 Campbell W, Hendrix E, Schwalbe R, Fattom A, Edelman R. Head-injured patients who are nasal carriers of Staphylococcus aureus are at high risk for Staphylococcus aureus pneumonia. Crit Care Med . 1999; 27 798-801
17 Sanchez Garcia M, Cambronero Galache J A, Lopez Diaz J. Effectiveness and cost of selective decontamination of the digestive tract in critically ill intubated patients: a randomized, double-blind, placebo-controlled, multicenter trial. Am J Respir Crit Care Med . 1998; 158 908-1016
18 Woeltje K F, Fraser V J. Preventing nosocomial infections in the intensive care unit: lessons learned from outcomes research. New Horiz . 1998; 6(1) 84-90
19 Kertesz D, Chow A W. Infected pressure and diabetic ulcers. Clin Geriatr Med . 1992; 8 835-852
20 Bryan C S, Dew C E, Reynolds K L. Bacteremia associated with decubitus ulcers. Arch Intern Med . 1983; 143 2093
21 Gellert G A, Waterman S H, Ewert D. An outbreak of acute gastroenteritis caused by a small round structured virus in a geriatric convalescent facility. Infect Control Hosp Epidemiol . 1990; 11 459-464