Pyrexia

After multiple trauma, burns, severe sepsis and major surgery, the gallbladder may become inflamed in the absence of gall stones. This inflammation, called acalculous cholecystitis, has an estimated incidence of around 1.5%.

• A wall thickness >3 mm
• intramural lucencies
• gallbladder distension
• pericholecystic fluid
• and intramural sludge

Eigentlich alle.

Drug fever ist eine Ausschlussdiagnose!

• all antibiotics (especially β-lactams)
• anti-epileptic drugs (especially phenytoin)
• antiarrhythmics (mainly quinidine and procainamide)
• antihypertensives (α-methyldopa)
• diuretics
• and stool softeners

myocardial infarction, Dressler's syndrome with pericarditis, thromboembolism, thrombolytic therapy with haemorrhagic complications and antiarrhythmic medication (e.g. procainamide, quinidine), and deep venous thrombosis

• advanced age
• underlying co-morbidity and the extent of trauma and surgery as well as
• prolonged hypotension
• haematoma
• foreign bodies and
• blood transfusion

Staphylokokken und Streptokokken

Reinigen der Wunde, Fremdkörperentferung,Drainage, und Sepsis-Therapie

After stroke or neurotrauma, fever may be associated with more severe brain damage and a worse neurological outcome->rapid assessment

s a neuropsychiatric disorder that may overlap the neuroleptic malignant syndrome. Fever, stupor, mutism, coma, muscle rigidity and autonomic instability are amongst the most prominent features.

• eliminating the underlying causes
• cooling (initially by infusion of cold intravenous fluids – see below)
• rehydration and benzodiazepines
• Intravenous dantrolene sodium to treat muscle contraction (1 mg/kg bolus) which may be repeated during the course of the illness is followed by 4–8 mg/kg per day in 3–4 doses, orally, for 3–4 days as ongoing prophylaxis
• Bromocriptine, other dopamine agonists (levodopa) and amantadine may also be used for neuroleptic malignant syndrome
• Electroconvulsive therapy may be necessary for catatonia if refractory to drug treatment.