Ateş
Özet
Ateş, bir birey için vücut sıcaklığının günlük aralığın üzerine çıkmasıdır. Acil servise erişkin başvurularının %6sını oluşturur. Enfektif ve non-enfeksiyöz onlarca nedeni vardır. Eksojen ve endojen pirojenler çeşitli mekanizmalarla hipotalamus ayar noktasını da değiştirerek ateşe neden olurlar. Acil serviste ilk dakikalarda kaçırılmaması gereken tanılar; sepsis, bakteriyel menenjit, nötropenik ateş ve nöroleptik malign sendromdur. Ateşe yol açan birçok hastalıkta yaklaşım; erken antibiyotik ve sıvı resisütasyonudur.
Referanslar
WHO. Fever measured temperature (04.03.2023 tarihinde https://www.who.int/data/gho/indicator-metadata-registry/imr-details/180 adresinden ulaşılmıştır.)
CDC. Definitions of Symptoms for Reportable Illnesses. (04.03.2023 tarfihinde https://www.cdc.gov/quarantine/air/reporting-deaths-illness/definitions-symptoms-reportable illnesses.html#:~:text=CDC%20considers%20a%20person%20to,history%20of%20feel ing%20feverish adresinden ulaşılmıştır)
Frederick C. Blum, Michelle H. Biros. Fever in the Adult Patient. in Rosen’s Emergency Medicine Concepts and Clinical Practice 9. ed. (p. 97) Philadelphia: ELSEVIER; 2018
Niven DJ, Gaudet JE, Laupland KB, et al. Accuracy of peripheral thermometers for estimating temperature: a systematic review and meta-analysis. Ann Intern Med 2015; 163:768.
Bone RC. Gram-negative sepsis: a dilemma of modern medicine. Clin Microbiol Rev 1993; 6:57.
Dinarello CA. Infection, fever, and exogenous and endogenous pyrogens: some concepts have changed. J Endotoxin Res 2004; 10:201.
Mackowiak PA, Wasserman SS, Levine MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA 1992; 268:1578.
Dinarello CA. Cytokines as endogenous pyrogens. J Infect Dis 1999; 179 Suppl 2:S294.
Shapiro L, Zhang XX, Rupp RG, et al. Ciliary neurotrophic factor is an endogenous pyrogen. Proc Natl Acad Sci U S A 1993; 90:8614.
Dinarello CA. Thermoregulation and the pathogenesis of fever. Infect Dis Clin North Am 1996; 10:433.
Coceani F, Bishai I, Lees J, Sirko S. Prostaglandin E2 and fever: a continuing debate. Yale J Biol Med 1986; 59:169.
Dinarello CA, Gatti S, Bartfai T. Fever: links with an ancient receptor. Curr Biol 1999; 9:R147.
Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:801.
Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med 2016; 193:259.
Takasu O, Gaut JP, Watanabe E, et al. Mechanisms of cardiac and renal dysfunction in patients dying of sepsis. Am J Respir Crit Care Med 2013; 187:509.
Elke G, Bloos F, Wilson DC, et al. The use of mid-regional proadrenomedullin to identify disease severity and treatment response to sepsis - a secondary analysis of a large randomised controlled trial. Crit Care 2018; 22:79.
Laura WELSH. Acil Tıbbın Temelleri. (Başak BAYRAM, Murat ÇETİN, Çev. ed.) Antalya: Kongre Tıp Kitabevi; 2018
Erdem H, Ozturk-Engin D, Cag Y, et al. Central nervous system infections in the absence of cerebrospinal fluid pleocytosis. Int J Infect Dis 2017; 65:107.
KLİMİK. Menenjitler. (04.03.2023 tarihinde https://www.klimik.org.tr/wp-content/uploads/2018/03/Menenjitler-Necla-T%C3%9CLEK.pdf adresinden ulaşılmıştır.)
Kaplan SL. Clinical presentations, diagnosis, and prognostic factors of bacterial meningitis. Infect Dis Clin North Am 1999; 13:579.
van de Beek D, de Gans J, Spanjaard L, et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 2004; 351:1849.
Shrikanth V, Salazar L, Khoury N, et al. Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance. Int J Infect Dis 2015; 39:39.
Thomas AE, Baird SF, Anderson J. Purpuric and petechial rashes in adults and children: initial assessment. BMJ 2016; 352:i1285.
Brouwer MC, Thwaites GE, Tunkel AR, van de Beek D. Dilemmas in the diagnosis of acute community-acquired bacterial meningitis. Lancet 2012; 380:1684.
Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 2001; 345:1727.
Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis 2011; 52:e56.
From the Immunocompromised Host Society. The design, analysis, and reporting of clinical trials on the empirical antibiotic management of the neutropenic patient. Report of a consensus panel. J Infect Dis 1990; 161:397.
Hirsch HH, Martino R, Ward KN, et al. Fourth European Conference on Infections in Leukaemia (ECIL-4): guidelines for diagnosis and treatment of human respiratory syncytial virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. Clin Infect Dis 2013; 56:258.
Schimpff S, Satterlee W, Young VM, Serpick A. Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. N Engl J Med 1971; 284:1061.
Referanslar
WHO. Fever measured temperature (04.03.2023 tarihinde https://www.who.int/data/gho/indicator-metadata-registry/imr-details/180 adresinden ulaşılmıştır.)
CDC. Definitions of Symptoms for Reportable Illnesses. (04.03.2023 tarfihinde https://www.cdc.gov/quarantine/air/reporting-deaths-illness/definitions-symptoms-reportable illnesses.html#:~:text=CDC%20considers%20a%20person%20to,history%20of%20feel ing%20feverish adresinden ulaşılmıştır)
Frederick C. Blum, Michelle H. Biros. Fever in the Adult Patient. in Rosen’s Emergency Medicine Concepts and Clinical Practice 9. ed. (p. 97) Philadelphia: ELSEVIER; 2018
Niven DJ, Gaudet JE, Laupland KB, et al. Accuracy of peripheral thermometers for estimating temperature: a systematic review and meta-analysis. Ann Intern Med 2015; 163:768.
Bone RC. Gram-negative sepsis: a dilemma of modern medicine. Clin Microbiol Rev 1993; 6:57.
Dinarello CA. Infection, fever, and exogenous and endogenous pyrogens: some concepts have changed. J Endotoxin Res 2004; 10:201.
Mackowiak PA, Wasserman SS, Levine MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA 1992; 268:1578.
Dinarello CA. Cytokines as endogenous pyrogens. J Infect Dis 1999; 179 Suppl 2:S294.
Shapiro L, Zhang XX, Rupp RG, et al. Ciliary neurotrophic factor is an endogenous pyrogen. Proc Natl Acad Sci U S A 1993; 90:8614.
Dinarello CA. Thermoregulation and the pathogenesis of fever. Infect Dis Clin North Am 1996; 10:433.
Coceani F, Bishai I, Lees J, Sirko S. Prostaglandin E2 and fever: a continuing debate. Yale J Biol Med 1986; 59:169.
Dinarello CA, Gatti S, Bartfai T. Fever: links with an ancient receptor. Curr Biol 1999; 9:R147.
Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:801.
Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med 2016; 193:259.
Takasu O, Gaut JP, Watanabe E, et al. Mechanisms of cardiac and renal dysfunction in patients dying of sepsis. Am J Respir Crit Care Med 2013; 187:509.
Elke G, Bloos F, Wilson DC, et al. The use of mid-regional proadrenomedullin to identify disease severity and treatment response to sepsis - a secondary analysis of a large randomised controlled trial. Crit Care 2018; 22:79.
Laura WELSH. Acil Tıbbın Temelleri. (Başak BAYRAM, Murat ÇETİN, Çev. ed.) Antalya: Kongre Tıp Kitabevi; 2018
Erdem H, Ozturk-Engin D, Cag Y, et al. Central nervous system infections in the absence of cerebrospinal fluid pleocytosis. Int J Infect Dis 2017; 65:107.
KLİMİK. Menenjitler. (04.03.2023 tarihinde https://www.klimik.org.tr/wp-content/uploads/2018/03/Menenjitler-Necla-T%C3%9CLEK.pdf adresinden ulaşılmıştır.)
Kaplan SL. Clinical presentations, diagnosis, and prognostic factors of bacterial meningitis. Infect Dis Clin North Am 1999; 13:579.
van de Beek D, de Gans J, Spanjaard L, et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 2004; 351:1849.
Shrikanth V, Salazar L, Khoury N, et al. Hypoglycorrhachia in adults with community-acquired meningitis: etiologies and prognostic significance. Int J Infect Dis 2015; 39:39.
Thomas AE, Baird SF, Anderson J. Purpuric and petechial rashes in adults and children: initial assessment. BMJ 2016; 352:i1285.
Brouwer MC, Thwaites GE, Tunkel AR, van de Beek D. Dilemmas in the diagnosis of acute community-acquired bacterial meningitis. Lancet 2012; 380:1684.
Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 2001; 345:1727.
Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis 2011; 52:e56.
From the Immunocompromised Host Society. The design, analysis, and reporting of clinical trials on the empirical antibiotic management of the neutropenic patient. Report of a consensus panel. J Infect Dis 1990; 161:397.
Hirsch HH, Martino R, Ward KN, et al. Fourth European Conference on Infections in Leukaemia (ECIL-4): guidelines for diagnosis and treatment of human respiratory syncytial virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. Clin Infect Dis 2013; 56:258.
Schimpff S, Satterlee W, Young VM, Serpick A. Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. N Engl J Med 1971; 284:1061.
