Chapter 8-05: Key Clinical Trials & Publications in Infectious Diseases

FEVER OF UNKNOWN ORIGIN

• Fever and fever of unknown origin: Review, recent advances, and lingering dogma. Open Forum Infect Dis 2020;7(5): ofaa132.

  • - A review article that integrates new data on fever of unknown origin (FUO) into the clinical approach and diagnosis and considers how this new data should influence clinical decision making and definitions of FUO.

NEUTROPENIC FEVER

• [Guideline] Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of America. Clin Infect Dis 2011;52(4):e56–93.

  • - This clinical practice guideline from the IDSA is intended to guide the use of antimicrobial agents in patients with cancer who develop fever in the setting of chemotherapy-induced neutropenia. It includes the risk stratification algorithm to determine which patients are at high- and low-risk of complications.

• [Guideline] Outpatient management of fever and neutropenia in adults treated for malignancy: American society of clinical oncology and infectious diseases society of America clinical practice guideline update summary. J Oncol Pract 2018;14(4):250–255.

  • - This guideline seeks to answer questions around which patients with fever and neutropenia can be managed as outpatients. It also includes recommendations on the basic workup of febrile neutropenia.

• Antimicrobial-resistant Gram-negative bacteria in febrile neutropenic patients with cancer: Current epidemiology and clinical impact. Curr Opin Infect Dis 2014;27(2):200–210.

  • - A review that examines recent trends in epidemiology and antimicrobial resistance in Gram-negative infections in neutropenic cancer patients. It pays particular attention to the impact of antimicrobial resistance on the outcomes of severe infections caused by these organisms.

FEVER IN A RETURNING TRAVELER

• Approach to Fever in the Returning Traveler. N Engl J Med 2017;376(6):548–560.

  • - This review focuses on epidemiologic features of infections in traveling patients and offers an approach to life-threatening and highly transmissible infectious diseases that commonly impact travelers. It includes key information on geography, incubation period, and transmission of clinically relevant infections in travelers.

CNS INFECTIONS

• Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev 2015;2015(9):CD004405.

  • - A systematic review of 25 randomized trials that included data from 4121 patients and examined outcomes and adverse effects of corticosteroid use for acute bacterial meningitis. Corticosteroids significantly reduced hearing loss and neurological sequelae but did not reduce overall mortality. This review supports the use of corticosteroids in patients with bacterial meningitis.

• Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 2001;345(24):1727–1733.

  • - A prospective cohort study of 301 adults with suspected meningitis. Clinical features associated with an abnormal finding on CT of the head were an age of at least 60 yr, immunocompromise, a history of CNS disease, and a history of seizure within a week of presentation. The following neurologic abnormalities were also associated with abnormal imaging: An abnormal level of consciousness, an inability to answer two consecutive questions correctly ...