Defining fever: likelihood of infection diagnosis as a function of body temperature in the emergency department

Abstract

Introduction: During the course of systemic inflammation, most of the immune cell types get activated to a certain degree as part of, or contributing to, the cascade of physiopathological events. Whether for some cells, classically phagocytes of the innate immune system, it is clear that direct sensing of pathogen-associated molecular patterns leads to activation initiating systemic inflammation, the picture is not so clear for natural killer (NK) cells. While NK cells have been shown to express toll-like receptors (TLR), the role of these receptors on NKs during systemic inflammation has not been directly addressed. Methods: To directly assess the role of TLR expression on NK cells we used an adoptive transfer model in which NKs purified from the spleens of WT, TLR4KO and TLR2/4DKO mice were transferred intravenously to RAG2-/γc-/-(devoid of T, B and NK cells). Five days after reconstitution the mice were challenged intraperitoneally with conventional or TLR-grade lipopolysaccharide (LPS). Immune cell activation and production of IFNγ by NK cells was determined after 6 hours by FACS analysis. Results: We observed no differences in reconstitution of the recipient mice with NK cells from different backgrounds suggesting no difference in trafficking and survival of the transferred cells. At 6 hours after LPS challenge, WT, TLR4KO or TLR2/4DKO NK cells recovered from the spleen and lungs of RAG2-/γc-/mice showed comparable levels of CD69 activation marker expression. Intracellular labeling for IFNγ in NK cells also revealed no significant differences. Conclusion: Whether there is a role for direct TLR signaling on NK cells remains the objective of further investigations; however, our data show that in the course of a systemic inflammatory process, like endotoxinemia, the expression of TLR2 and TLR4 by NK cells makes no difference in terms of their activation and secretion of IFNγ P2 Role of 6-hour, 12-hour, and 24-hour lactate clearance in mortality of severe sepsis and septic shock patients.

Invasive bacterial infections in Gambians with sickle cell anemia in an era of widespread pneumococcal and hemophilus influenzae type b vaccination

“…For cultural and practical reasons, all patients admitted have axillary temperature measured, and for the purpose of this study, a fever cut-off value of ≥37.5°C was selected, which has been shown to increase sensitivity for predicting infection without greatly impacting specificity. [18] …”

Stress Hyperglycemia as Predictive Factor of Recurrence in Children with Febrile Seizures

“…We defined the cohort by applying the age criterion according to the revised ILAE (International League of Epilepsy) definition, namely age ranging between one month to five years [23]. A febrile context was documented if the temperature was higher than 37.5 • C prior to seizure event (up to 4 h) or immediately following the seizure event [24]. The simple febrile seizure was defined as a primary generalized seizure, lasting under 15 min and not recurring within 24 h. Complex febrile seizures were categorized as focal or prolonged seizures (>15 min) or seizures' recurrence within 24 h [23].…”

Prognostic indicators for in-hospital mortality in COPD with acute exacerbation in Thailand: a retrospective cohort study

“…All the prognostic factors thresholds were chosen based on previous literature and clinical experiences: (1) age ≥ 80 years; advance age, 23 (2) BT≥38°C; represent fever, 24 (3) MAP <65 mm Hg; international sepsis guideline, 25 (4) serum creatinine (SCr) ≥1.5 mg/dL; presence of initial renal insufficiency. Although the 26 Kidney Disease: Improving Global Outcomes (KDIGO) on acute kidney injury (AKI) suggested the increase in SCr (>1.5 times of baseline) rather than single SCr value, we recognised that many COPD patients did not have baseline SCr information on evaluation.…”