Occult fever in surgical intensive care unit patients is seldom caused by sinusitis

Borman, Karen R.; Brown, Phillip M.; Mezera, Kimberly K.; Jhaveri, Harish S.

doi:10.1016/s0002-9610(05)81171-7

Cited by 43 publications

(35 citation statements)

References 24 publications

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“…Rhinosinusitis and otitis media are two major diseases of otorhinolaryngology, which can lead to sepsis, even a little, and which have high potential, especially for intracranial complications (15,16). Also, in our study, intracranial complication associated with the middle ear was observed in 1 patient.…”

Section: Discussionsupporting

confidence: 52%

Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care

Akdağ¹,

Cetin²,

Baysal³

et al. 2014

Turk Arch Otolaryngol

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Objective: To assess the probable agents affecting middle ear pressure in intubated patients hospitalized in intensive care units with various diagnoses.Methods: Middle ear pressure of 38 patients hospitalized in intensive care units within our faculty hospital was measured using portable tympanograms and acoustic reflectometry. The mode of the device to which each patient was attached and patients' blood pressure, Glasgow Coma Score, and additional disease parameters other than admission diagnosis were recorded. All data collected were subjected to statistical analysis to determine whether or not they affected middle ear pressure.Results: Septal deviation, survey, and mode of automatic respiratory device emerged as factors affecting middle ear pressure (odds coefficient 4.796, 3.745, 2.557, respectively, with 95% CI). Although aged over 60, additional disease and nasogastric tube also compromised middle ear pressure; the levels involved were not statistically significant. Conclusion:Middle ear pressure in patients hospitalized in intensive care units may change, particularly after the seventh day. This may particularly involve septal deviation, survey, and mode of automatic respiratory device, and tympanograms and reflectometry may be added to the patient-monitoring protocol in terms of changes in middle ear pressure.

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Section: Discussionsupporting

confidence: 52%

Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care

Akdağ¹,

Cetin²,

Baysal³

et al. 2014

Turk Arch Otolaryngol

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“…Although it is rare, the possibility for developing sepsis was reported in intensive care patients with acute otitis media or sinusitis (11,12). In our study, no patient had sepsis, and it was believed that this might have resulted because patients received systematic antibiotherapy and OME was not complicated with suppurative otitis media.…”

Section: Discussionmentioning

confidence: 51%

Evaluation of Prevalence and Factors Affecting the Development of Middle Ear Effusion in Patients with Prolonged Intubation in Intensive Care Unit

Dizdar¹,

Dinç²,

Ulusoy³

et al. 2015

JAREM

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Objective: Monitorization of patients in intensive care units requires a multidisciplinary approach. As cooperation with unconscious or intubated patients is often not possible, some conditions may be overlooked. The aim of this study is to reveal the incidence and factors affecting otitis media with effusion in ICU patients intubated longer than 7 days.Methods: Twenty patients hospitalized in the intensive care unit of the Gaziosmanpaşa Taksim Training and Research Hospital from March to December 2014 were included in the study. The Gaziosmanpaşa Taksim Training and Research Hospital Ethics Committee approved the study according to the Declaration of Helsinki and Good Clinical Practices guidelines. All of the patients included in the study were aged ≥18 years. Patients intubated because of traffic accidents or trauma, patients with a history of chronic otitis media or ear, nose, and throat operations, patients with head and neck tumors, and patients with tympanic membrane perforation, external auditory canal pathology, nasopharyngeal mass, and chronic sinusitis as well as patients with a pathology leading to nasal obstruction, such as nasal polyposis or severe septal deviation, were excluded. After a detailed history by patients' relatives, an otoscopic examination, nasal examination, tympanometry, and acoustic reflex measurements were performed. Ear examination was performed using a conventional portable otoscope.Results: Among 20 patients, 12 had bilateral effusion (24 out of 40 ears, 60%). In two patients, a type C tympanogram was obtained (four out of 40 ears, 10%), and the remaining 12 ears of six patients were normal (30%). When intubation time is evaluated, among 13 patients intubated longer than 14 days, 11 had effusion (84%). A significant correlation was found between the duration of intubation and effusion development. Assessing the state of consciousness, 11 of 12 unconscious patients (91%) were found to have effusion. There was a significant correlation between effusion development and state of consciousness. Conclusion:In unconscious patients intubated longer than 14 days, the risk of having middle ear effusion is demonstrated to be higher. Consequently, in the periodic follow-up of intensive care patients with prolonged intubation, a routine otoscopic examination has to be considered. (JAREM 2015; 5: 64-7)

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“…Onset of defervescence (reduction on the number of daily peaks of fever) within 48 to 72 hours 16,17 or abolition of fever within five days of the procedure 17 where used to characterize the success of the puncture procedure. The same criteria was used to assess the success of FESS 16,17,22,23 . Fifty-four nasal cavities were analyzed through CT scans.…”

Section: Resultsmentioning

confidence: 99%

“…This procedure may also be a relevant tool in the treatment of critical patients with IRS 8,12,22,26,30 . This study revealed that 70.4% of the patients improved from their fever episodes after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Papel da punção do seio maxilar no diagnóstico e no tratamento de pacientes com rinossinusite hospitalar

Neto¹,

Guerreiro²,

Hirai³

et al. 2012

Braz. j. otorhinolaryngol.

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Rhi nosinusitis is one of the most commom causes of fever of unknown origin in critically ill patients and should be systematically searched.Objective: This study aims to evaluate the diagnostic and therapeutic effect of maxillary sinus puncture performed at the bedside in patients with infective rhinosinusitis hospitalized in an Intensive Care Unit of a high complexity care hospital. Materials and Methods:This retrospective study looks into patients on mechanical ventilation with fever of unknown origin and signs of rhinosinusitis on CT images who were submitted to inferior meatus maxillary sinus puncture. Results:The total study sample consisted of 27 patients (70.3% male; mean age 45.3 years). The most common Intensive Care Unit admission diagnoses were head trauma and stroke. CT scans revealed the maxillary (85.2%) and sphenoid (74.1%) sinuses were the most involved paranasal sinuses. Middle meatus purulent drainage was seen in 30.7% of the nasal cavities. Fever was reduced in 70.4% of the patients after puncture (p < 0.001). The most commonly found organisms in sinus aspirates were Pseudomonas aeruginosa and Acinetobacter baumannii. Conclusion:Maxillary sinus puncture performed at the bedside of the patients is an important diagnostic and theraupetic tool for critically ill patients. Braz J Otorhinolaryngol. 2012;78(4):35-41. BJORL ORIGINAL ARTICLE

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Occult fever in surgical intensive care unit patients is seldom caused by sinusitis

Cited by 43 publications

References 24 publications

Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care

Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care

Evaluation of Prevalence and Factors Affecting the Development of Middle Ear Effusion in Patients with Prolonged Intubation in Intensive Care Unit

Papel da punção do seio maxilar no diagnóstico e no tratamento de pacientes com rinossinusite hospitalar

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