PAUL R. MARANTZ, M.D.; MARK LINZER, M.D.; CHERYL J. FEINER, M.P.H.; STUART A. FEINSTEIN, M.D.; ARTHUR M. KOZIN, M.D.; GERALD H. FRIEDLAND, M.D.
▸Requests for reprints should be addressed to Paul Marantz, M.D., Department of Epidemiology and Social Medicine, Montefiore Medical Center, 111 E. 210 Street, Bronx, NY 10467.
MARANTZ P., LINZER M., FEINER C., FEINSTEIN S., KOZIN A., FRIEDLAND G.; Inability to Predict Diagnosis in Febrile Intravenous Drug Abusers. Ann Intern Med. 1987;106:823-828. doi: 10.7326/0003-4819-106-6-823
Download citation file:
Published: Ann Intern Med. 1987;106(6):823-828.
Although hospitalization is recommended for all febrile intravenous drug abusers, this practice has not been tested and validated. To determine the distribution of disease and the predictive value of clinical information available in the emergency room for diagnosis in these patients, we prospectively evaluated the clinical and laboratory data for 87 consecutive admissions involving 75 intravenous drug abusers with temperature of 38.1 °C or more, emergency room physicians' diagnostic predictions, and final diagnosis. Final diagnoses were pneumonia in 38% of the patients, trivial illness (viral syndrome, pharyngitis, or pyrogen reaction) in 26%, infective endocarditis in 13%, and other conditions in 23%. Neither emergency room physicians' diagnostic predictions nor clinical data correlated with a final diagnosis of endocarditis. Although physicians' prediction of trivial illness was associated with a final diagnosis of trivial illness (p < 0.05), 29% of these patients had a more serious final diagnosis. These data confirm the need to hospitalize all intravenous drug abusers presenting with fever at an emergency room.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Tobacco, Alcohol, and Other Substance Abuse.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only