Fever in the critical care unit

Fever in the critical care unit (CCU) may be on an infectious or noninfectious basis. Many noninfectious disorders have clinical and laboratory features mimicking infections. The main clinical dilemma in the febrile CCU patient is to differentiate between noninfectious and infectious disease. Antibiotic treatment of colonization or noninfectious conditions is unnecessary, wasteful, likely to cause resistance problems, and may result in serious side effects. Selection of appropriate antibiotic therapy is straightforward once the likely source of sepsis is determined. This article provides a clinical diagnostic approach.