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Causes of fever in patients infected with human immunodeficiency virus who were admitted to Boston City Hospital.
Barat LM; Gunn JE; Steger KA; Perkins CJ; Craven DE; Maxwell Finland
February 28, 1997
Clin Infect Dis. 1996 Aug;23(2):320-8. Unique Identifier : AIDSLINE

We prospectively studied causes of fever in patients with human immunodeficiency virus (HIV) infection that required admission to a municipal hospital. A total of 168 HIV-infected persons were admitted for 220 episodes of fever: 72% were male, 80% were nonwhite, 65% reported prior injection drug use, and 74% had a baseline CD4 lymphocyte count of < 200/mm3. Bacterial infections, principally pneumonia, accounted for > 60% of the episodes; Streptococcus pneumoniae and Staphylococcus aureus were most commonly isolated. Pneumocystis carinii pneumonia (PCP) and disseminated infection with Mycobacterium avium complex (MAC) comprised 53% of the remaining sources of fever. In comparison with episodes of fever due to nonbacterial causes, those associated with common bacterial infections were significantly more likely to involve patients with a history of injection drug use (P = .02), higher admission leukocyte count (P < .004), shorter duration of fever (P = .003), shorter hospital stays (P = .0001), and a CD4 count of > 100/mm3 (P = .002). We conclude that bacterial infection, especially pneumonia, is a common cause of fever in HIV-infected patients admitted to our hospital. Patients with bacterial infections are more likely to report a history of injection drug use and have CD4 counts of > 100/mm3, shorter duration of fever, decreased length of hospitalization, and lower mortality than patients with fever due to PCP, disseminated MAC infection, or other causes.

Adolescence Adult Aged AIDS-Related Opportunistic Infections/DIAGNOSIS/*ETIOLOGY/ PHYSIOPATHOLOGY Bacterial Infections/DIAGNOSIS/PHYSIOPATHOLOGY Female Fever/DIAGNOSIS/*ETIOLOGY/PHYSIOPATHOLOGY Hospitals Human Male Middle Age Outcome Assessment (Health Care) Prospective Studies JOURNAL ARTICLE