SINGH N, GAYOWSKI T, WAGENER MM, MARINO IR; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 633 (abstract no. 1691).
VA Med. Ctr., Pittsburgh, PA.
BACKGROUND: Infections in immunocompromised hosts may not be invariably accompanied by a febrile response. However, the etiologies and prognosis of infections associated with lack of fever (hypothermia or euthermia) in liver transplant recipients, has not been defined.METHODS: Prospective, observational study of 96 consecutive liver transplant recipients with infection. An additional 13 patients had fever of non-infectious etiologies.RESULTS: 68% (65/96) of the patients with infection were febrile. 27% (26/96) were euthermic and 5% (5/96) were hypothermic. Of infections associated with hypothermia, 80% (4/ 5) were pneumonia; the etiologic pathogens included Legionella pneumophila 1, E. cloacae 1, E. coli 1, and invasive aspergillosis 1. 51% of the febrile, 50% of euthermic but 100% of the hypothermic infections occurred in the ICU setting. APACHE II score (p=.04) and APS score (p=.017) of the hypothermic patients were significantly higher than those of febrile or euthermic patients with infections. Bacteremia was documented in 51% of the febrile, 15% of the afebrile but 80% of the hypothermic patients (p=.005). Mortality at 30 days was 20% (13/65) in febrile, 23% (6/26) in euthermic and 100% (5/5) in hypothermic patients (p=.0006).CONCLUSION: In liver transplant recipients, bacteremic pneumonia is the most common cause of hypothermia. The physiologic response to infections (as indicated by higher APS score) was significantly more florid in hypothermic as compared to febrile or euthermic infections. Hypothermic infections portended a grave outcome, with 100% mortality.
Publication Types:
Keywords:
- Aspergillosis
- Bacteremia
- Body Temperature
- Fever
- Humans
- Hypothermia
- Infection
- Intensive Care Units
- Liver Transplantation
- Physical Examination
- Pneumonia
- Prospective Studies
- diagnosis
- etiology
- methods
- surgery
- transplantation
Other ID:
UI: 102246218
From Meeting Abstracts