IBCC Episode 90 - Fever

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss the nuances of fever and rigors in the ICU, emphasizing that fever evaluation should be thoughtful and thorough, not a reflexive ordering of tests. They define fever, differentiate it from hyperthermia, and discuss community-acquired versus ICU-acquired fevers, as well as neutropenic fever. They cover common infectious and non-infectious causes of fever in the ICU, including pneumonia, C. difficile, drug fever, and sterile pulmonary infections. The hosts also discuss the importance of physical exams and targeted evaluations, cautioning against routine urine and tracheal aspirate cultures. The speakers address management strategies, including the limited role of antipyretics and the importance of identifying and treating the underlying cause of the fever, and they delve into drug fever and neurogenic fever, highlighting diagnostic challenges and treatment approaches.