Rabinstein and Sandhu studied patients in the neurological intesntive care unit (ICU) with non-infectious fever. The authors are from Jackson Memorial Hospital and the University of Miami.
Patient selection: neurologic ICU
Predictors of non-infectious fever:
(1) subarachnoid hemorrhage, especially with vasospasm
(2) onset within the first 72 hours of the admission
In the absence of these findings there is considerable overlap between infectious and non-infectious fevers.
In a patient with one or both of these findings:
(1) If the patient does not have other evidence of infection, then consider withholding antibiotics pending culture results.
(2) If antibiotics are started, then discontinue if cultures are negative.
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