HOSPITAL-ACQUIRED FEVER IN ADULTS: A PRACTICAL DIAGNOSTIC APPROACH FOR CLINICIANS.
Authors/Creators
- 1. Faculty of Medicine, Universidad Cooperativa. Colombia
- 2. Faculty of Health Sciences, Universidad Icesi. Cali, Colombia.
- 3. Faculty of Health Sciences, Universidad Icesi. Cali, Colombia
- 4. Instituto Colombiano del Dolor
Description
Article type: Review article
Introduction: Hospital-acquired fever is a common clinical syndrome with a broad differential diagnosis that includes both infectious and non-infectious conditions. Its evaluation remains challenging because indiscriminate diagnostic testing and empirical antimicrobial therapy may increase morbidity, healthcare costs, and antimicrobial resistance. An evidence-based practical diagnostic approach for adults who develop fever during hospitalization is presented.
Methods: A narrative review was conducted using PubMed/MEDLINE, Scopus, and Google Scholar. Systematic reviews, meta-analyses, clinical practice guidelines, consensus statements, and relevant observational studies published between January 2000 and May 2026 were critically appraised and synthesized to develop a practical diagnostic framework.
Results: A stepwise diagnostic approach is proposed based on clinical stability, timing of fever onset, systematic bedside reassessment, and identification of the most likely anatomical source. The review summarizes the major infectious and non-infectious etiologies, the role of microbiological studies, imaging modalities, and biomarkers, and highlights common diagnostic pitfalls. These concepts are integrated into a practical diagnostic algorithm aimed at improving diagnostic accuracy and promoting appropriate antimicrobial use.
Conclusions: The evaluation of hospital-acquired fever should rely on clinical judgment, repeated bedside reassessment, and the judicious use of diagnostic tests. A structured diagnostic approach may improve diagnostic accuracy, reduce unnecessary investigations, and support more appropriate antimicrobial use.
Abstract (Spanish)
Tipo de artículo: Artículo de revisión
Introducción: La fiebre intrahospitalaria constituye un síndrome clínico frecuente con un amplio diagnóstico diferencial que incluye causas infecciosas y no infecciosas. Su evaluación representa un desafío clínico, ya que el uso indiscriminado de estudios diagnósticos y antimicrobianos puede incrementar la morbilidad, los costos y la presión selectiva para resistencia bacteriana. Se describe un enfoque diagnóstico práctico y basado en la evidencia para la evaluación del adulto con fiebre durante la hospitalización.
Métodos: Se realizó una revisión narrativa de la literatura mediante búsquedas en PubMed/MEDLINE, Scopus y Google Scholar. Se incluyeron revisiones sistemáticas, metaanálisis, guías de práctica clínica, documentos de consenso y estudios observacionales relevantes publicados entre enero de 2000 y mayo de 2026. La evidencia se analizó de forma crítica y se organizó para desarrollar un algoritmo diagnóstico aplicable a la práctica clínica.
Resultados: Se propone un abordaje escalonado basado en la estabilidad clínica, la cronología de la fiebre, la reevaluación clínica sistemática y la identificación del foco anatómico más probable. Se revisan las principales causas infecciosas y no infecciosas, el papel de los estudios microbiológicos, las técnicas de imagen y los biomarcadores, así como los errores diagnósticos más frecuentes. Se integra esta información en un algoritmo práctico orientado a optimizar el rendimiento diagnóstico y racionalizar la utilización de antimicrobianos.
Conclusiones: La evaluación de la fiebre intrahospitalaria debe fundamentarse en el juicio clínico, la reevaluación seriada y el uso dirigido de pruebas diagnósticas. Un enfoque estructurado permite mejorar la precisión diagnóstica, reducir estudios innecesarios y favorecer una utilización más racional de los antimicrobianos.
Files
sanum_v10_n4_a9.pdf
Additional details
Additional titles
- Translated title (Spanish)
- FIEBRE INTRAHOSPITALARIA EN ADULTOS: UN ENFOQUE DIAGNÓSTICO PRÁCTICO PARA EL CLÍNICO
Dates
- Collected
-
2026-07-20manuscrito recibido
- Accepted
-
2026-09-10evaluación doble ciego
- Available
-
2026-10-30publicación en numero de la revista
Software
- Repository URL
- https://revistacientificasanum.com/
- Development Status
- Active
References
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