medicina56巻4号

2019年04月発行

増刊号 一人でも慌てない！—「こんなときどうする？」の処方箋85 どうする?　感染症

59　この発熱は経過観察でよいか? 精査すべきか?

著者： 上田剛士¹

所属機関： ¹洛和会丸太町病院救急・総合診療科

ページ範囲：P.322 - P.325

症例呈示
発熱のため，往診依頼のあった86歳女性．
・38.0℃の発熱と倦怠感があるが，咳や鼻水はなく，痛い場所もない．
・既往：高血圧，脳梗塞後遺症．
・ADL：杖歩行．

参考文献

1）Williams JM, et al：Systemic inflammatory response syndrome, Quick Sequential Organ Function Assessment, and organ dysfunction；Insights from a prospective database of ED patients with infection. Chest 151：586-596, 2017

2）Raith EP, et al：Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the Intensive Care Unit. JAMA 317：290, 2017

3）Freund Y, et al：Prognostic accuracy of Sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA 317：301-308, 2017

4）Askim Å, et al：Poor performance of quick-SOFA（qSOFA）score in predicting severe sepsis and mortality-a prospective study of patients admitted with infection to the emergency department. Scand J Trauma Resusc Emerg Med 25：56, 2017

5）González Del Castillo J, et al：Prognostic accuracy of SIRS criteria, qSOFA score and GYM score for 30-day-mortality in older non-severely dependent infected patients attended in the emergency department. Eur J Clin Microbiol Infect Dis 36：2361-2369, 2017

6）Takeshima T, et al：Identifying patients with bacteremia in community-hospital emergency rooms；A retrospective cohort study. PLoS One 11：e0148078, 2016

7）Komatsu T, et al：A simple algorithm for predicting bacteremia using food consumption and shaking chills；A prospective observational study. J Hosp Med 12：510-515, 2017

8）Lee CC, et al：Comparison of clinical manifestations and outcome of community-acquired bloodstream infections among the oldest old, elderly, and adult patients. Medicine 86：138-144, 2007