Common Cause Of Fever Research Articles

Bloodstream bacterial infection among outpatient children with acute febrile illness in north-eastern Tanzania.

BackgroundFever is a common clinical symptom in children attending hospital outpatient clinics in rural Tanzania, yet there is still a paucity of data on the burden of bloodstream bacterial infection among these patients.MethodsThe present study was conducted at Korogwe District Hospital in north-eastern Tanzania. Patients aged between 2 and 59 months with a history of fever or measured axillary temperature ≥37.5°C attending the outpatient clinic were screened for enrolment into the study. Blood culturing was performed using the BACTEC 9050® system. A biochemical analytical profile index and serological tests were used for identification and confirmation of bacterial isolates. In-vitro antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. The identification of Plasmodium falciparum malaria was performed by microscopy with Giemsa stained blood films.ResultsA total of 808 blood cultures were collected between January and October 2013. Bacterial growth was observed in 62/808 (7.7%) of the cultured samples. Pathogenic bacteria were identified in 26/808 (3.2%) cultures and the remaining 36/62 (58.1%) were classified as contaminants. Salmonella typhi was the predominant bacterial isolate detected in 17/26 (65.4%) patients of which 16/17 (94.1%) were from patients above 12 months of age. Streptococcus pneumoniae was the second leading bacterial isolate detected in 4/26 (15.4%) patients. A high proportion of S.typhi 11/17 (64.7%) was isolated during the rainy season. S. typhi isolates were susceptible to ciprofloxacin (n = 17/17, 100%) and ceftriaxone (n = 13/17, 76.5%) but resistant to chloramphenicol (n = 15/17, 88.2%). P. falciparum malaria was identified in 69/808 (8.5%) patients, none of whom had bacterial infection.ConclusionBloodstream bacterial infection was not found to be a common cause of fever in outpatient children; and S. typhi was the predominant isolate. This study highlights the need for rational use of antimicrobial prescription in febrile paediatric outpatients presenting at healthcare facilities in rural Tanzania.

Multi-resistant gram negative enteric bacteria causing urinary tract infection among malnourished underfives admitted at a tertiary hospital, northwestern, Tanzania.

BackgroundInfections are common complications occurring in malnourished childrenas a result of impaired immunity. Urinary tract infections (UTI) have been found to be the commonest cause of fever in normal children in developing countries. However, data regarding UTI among malnourished children is limited because in most of time severe and moderately malnourished children are afebrile despite significant bacteriuria.MethodsA total of 402 malnourished underfives were enrolled. Demographic and other clinical characteristics were collected using standardized data collection tool. Urine specimens were cultured and interpreted according to standard operating procedures. Data were analyzed using STATA version 11.ResultsOut of 402 malnourished underfives, 229 (56.9 %) were male. The median age in months was 17 (IQR; 12–31). Of 402 malnourished underfives, 83 (20.3 %) had significant bacteriuria of gram negative enteric bacteria. Escherichia coli 35/84 and Klebsiella pneumonia 20/84 were predominant bacteria isolated. More than 37 % of isolates were resistant to third generation cephalosporins with all of them exhibiting extended spectrum beta lactamase (ESBL) phenotype. Rates of resistance to ampicillin, amoxillin/clavulanic acid, gentamicin and ciprofloxacin were 82/84 (98.7 %), 47/55 (85.4 %), 45/84 (57.8 %) and 9/84 (10.8 %) respectively. Decrease in age and increase in lymphocytes count were independent factors on multivariate logistic regression analysis found to predict UTI (p < 0.05).ConclusionsMulti-resistant gram negative enteric bacteria are common cause of UTI among underfives. A significant number of severe and moderate malnourished children with bacteriuria had no fever. Therefore, routine testing for UTI is emphasized in all malnourished underfives so that appropriate treatment can be initiated.

A prospective observational study of bacteraemia in adults admitted to an urban Mozambican hospital.

Bacteraemia is a common cause of fever among patients presenting to hospitals in sub-Saharan Africa. The worldwide rise of antibiotic resistance makes empirical therapy increasingly difficult, especially in resource-limited settings. To describe the incidence of bacteraemia in febrile adults presenting to Maputo Central Hospital (MCH), an urban referral hospital in the capital of Mozambique, and characterise the causative organisms and antibiotic susceptibilities. We aimed to describe the antibiotic prescribing habits of local doctors, to identify areas for quality improvement. Inclusion criteria were: (i) ≥18 years of age; (ii) axillary temperature ≥38°C or ≤35°C; (iii) admission to MCH medical wards in the past 24 hours; and (iv) no receipt of antibiotics as an inpatient. Blood cultures were drawn from enrolled patients and incubated using the BacT/Alert automated system (bioMérieux, France). Antibiotic susceptibilities were tested using the Kirby-Bauer disc diffusion method. Of the 841 patients enrolled, 63 (7.5%) had a bloodstream infection. The most common isolates were Staphylococcus aureus, Escherichia coli, and non-typhoidal Salmonella. Antibiotic resistance was common, with 20/59 (33.9%) of all bacterial isolates showing resistance to ceftriaxone, the broadest-spectrum antibiotic commonly available at MCH. Receipt of insufficiently broad empirical antibiotics was associated with poor in-hospital outcomes (odds ratio 8.05; 95% confidence interval 1.62 - 39.91; p=0.04). This study highlights several opportunities for quality improvement, including educating doctors to have a higher index of suspicion for bacteraemia, improving local antibiotic guidelines, improving communication between laboratory and doctors, and increasing the supply of some key antibiotics.

Extrapulmonary tuberculosis presented as fever of unknown origin in two patients with endstage kidney disease not on dialysis: usefulness of 18-FDG-PET/CT in the diagnostic localization of fever of unknown origin.

Tuberculosis is one of the common causes of fever of unknown origin in patients with chronic kidney disease (CKD). Extrapulmonary tuberculosis is more common in CKD patients, and is, unfortunately, often underdiagnosed despite extensive assessments. Recently, fluorine-18-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has been available in the diagnosis of malignancy, inflammatory and infectious diseases, and has become a useful diagnostic tool. Here, we present two cases of endstage kidney disease who presented with fever of unknown origin at the time of dialysis initiation. In both cases, although interferon-gamma-releasing assay was positive, combined conventional diagnostic modalities such as computed tomography and gallium-citrate scintigraphy failed to detect the sites infected with tuberculosis. By contrast, extrapulmonary lesions were detected by FDG-PET/CT and successfully treated with combined anti-tuberculous drugs. Diagnosis of extrapulmonary tuberculosis was confirmed by biopsy of the affected lymph node and lumbar spine, followed by PCR of the biopsied specimen. These cases highlight the importance of considering tuberculosis as one of the differential diagnoses in pre-dialysis CKD patients with persistent fever, and the usefulness of FDG-PET/CT in the detection of infectious sites of extrapulmonary tuberculosis.

African Tick-Bite Fever in a Returning Traveler

BackgroundAfrican tick bite fever (ATBF) is an emerging infection endemic to sub-Saharan Africa and increasingly noted in travelers to the region. Case ReportWe present a case of ATBF in a 63-year-old man who presented with complaints of a rash and fever to the emergency department. Why Should an Emergency Physician be Aware of This?Rickettsial diseases are increasingly common and are seen on every continent except Antarctica. Many factors are contributing to their prevalence, and they have become the second most common cause of fever behind malaria in the traveler returning from Africa. Due to the global distribution of rickettsial diseases, as well as increasing international travel, emergency physicians might encounter ill and febrile travelers. A careful travel history and examination will enable the emergency physician to consider spotted fever group rickettsial diseases in their differential diagnosis for single and multiple eschars.

English

AIM: To study the significance of platelet count in various fevers and also identify the common causes of fever with thrombocytopenia. MATERIALS AND METHODS: 69 patients who were admitted with fever over 2 months of period from 15th October to15th December 2014 in King George Hospital AMC Visakhapatnam studied retrospectively. RESULTS: INCIDENCE: More than half of the cases (52.2%) admitted with fever have thrombocytopenia. SEX: The study reveals that irrespective of sex and size of the sample the presentation of fever with/ without thrombocytopenia could not found any significant difference. Degree of thrombocytopenia in various etiologies: in the present study it is found that out of 15 cases of falciparum malaria 10 cases had thrombocytopenia. Out of 12 undiagnosed cases 8 cases had thrombocytopenia. Out of 4 cases of gastro intestinal system 3 cases had thrombocytopenia. In the present study it is significantly found that the highest difference is noticed in the presentation of dengue cases. Out of total sample (69) cases it is found that 5cases (7.2%) of thrombocytopenia with dengue fever were found against 1case (1.4%) of dengue fever with normal plate let count. The present study reveals that there is significant difference among various diseases such as malaria 14 (16.6%), dengue fever 5 (13.9%), Urinary tract infection 2 (5.6%), undiagnosed cases 8 (22.2%). However severe thrombocytopenia (platelets less than 50,000) is seen in14 cases (38.8%)out of 36 cases of fever with thrombocytopenia. Further this study reveals that in the cases of malaria 50% of cases reported as severe thrombocytopenia 7cases (19.4%) followed by dengue fever3 cases (8.3%). CONCLUSION: Not only malaria, dengue fever and urinary tract infection can also cause severe thrombocytopenia. Fever cases especially with thrombocytopenia show seasonal variations, they are seen commonly in early winter. Febrile thrombocytopenia still presents as atypical and occult forms making diagnosis difficult. This highlights the importance of thrombocytopenia in various febrile disorders. Hence, there is a need for study to know the importance of platelet count estimation in all types of fever as a basic investigation to establish correct diagnosis and prevent fatal outcome.

Self-treatment of Uncomplicated Malaria at Community Level in Masala Township, Ndola District, Zambia: Prevalence, Knowledge and Factors Influencing Self-treatment

Background: Malaria is the commonest cause of fever, morbidity and mortality in the tropics. A good number of people are able to recognize the symptoms and initiate treatment. However lack of clinical evaluation of the patients by trained health professionals, may delay appropriate treatment and promote drug resistant. Objective: To determine the prevalence of self-treatment of malaria among the people with regard to knowledge and factors that may influence health seeking behavior. Method: Community based cross section descriptive study carried among 365patients buying medicines from local drugstores. A structured questionnaire was used to gather data entered in Epi Data 3.1 and analysis done using SPSS version 16.0. To ascertain association between dependent and independent variables, binary logistic regression and variables with p-value of less than or equal to 0.05 were entered into multivariate regression analysis. Results: Among the 365 patients interviewed 150 bought antimalarials 150/365 (41.1%). The overall knowledge was 44.7% and significantly associated with income, education and occupation. Compared to respondents with income > K1000, respondents with income < K500 were 94% (AOR=0.06; 95% CI [0.01, 0.21]) less likely to be knowledgeable. Respondents with tertially education were 2.73 (95% CI [1.50, 4.89]) times more likely to be knowledgeable compared to respondents with primary education. Compared to respondents with othersa occupations, professionals were 5.97 (95% CI [2.27, 15.7]) times more likely to be knowledgeable. Sulfadoxine-pyrimethamine (fansidar) is by far the antimalaria drug that was used 51.3%. About 66.7% attributed to overcrowding and 72.7% to not being attended to in less than 2 hours upon arrival at health facility as reasons for not seeking treatment at government facilities. Conclusion: Prevalence of self-medication was high 41.1% and most people lacked adequate knowledge on malaria. The individual’s level of formal education, income and occupation were determinants knowledge.

Demographic, clinical &amp; laboratory profile in children with febrile seizures

Introduction: Febrile seizures are the most common seizures in children less than five years of age and occur in 2-5%. They are mostly benign with an excellent prognosis. Despite its benign nature, the febrile convulsion is one of the most common reasons for admission .The present study was aimed to study the demographic, clinical & laboratory profile in children admitted with febrile seizures for the first time and compare with other similar studies. Study Design: A descriptive prospective study conducted in a tertiary care centre. A l l children admitted with Febrile Seizure for the first time; aged 06 mo - 60mo were enrolled. Diagnostic criteria as per ??? Clinical Practice Guidelines, 2008 were used. Patient's demographic and clinical data were obtained. Laboratory investigation for each patient was guided by clinical examination. The cause for the fever was evaluated and managed with antibiotics wherever indicated .The data was analysed by using Microsoft Excel. Results: There were 75 children which constituted 5.7% of total Paediatric admissions. Mean age of presentation was 27.78mo (± 15.16 mo) with peak in less than 2 years of age. At presentation, Simple febrile seizure was observed in majority (85.3%). Mean duration of seizure was 1.25 (± 1.23 ) min. Majority of children (n=54, 72%) developed seizure within 24 hours of onset of fever and around 17.3% had positive family history. The upper respiratory tract infection was the most common cause of fever (92%) and around 84.1 % did not require antibiotics. Around 44% of children had microcytic hypochromic anaemia. Recurrence was observed in 4% of patients. The average length of stay (ALS) was 3.4 (+1-2.4) days. Conclusions: Parents should be appropriately counselled regarding prophylaxis and benign nature of illness. The yield of investigation remains low and does not justify extensive workup or prolonged hospitalization. As most of the cases are of viral etiology, antibiotics should be used with discretion.

Is scrub typhus a cause of febrile illness among paediatric population of delhi?

Sir, Scrub typhus is a febrile illness caused by Orientia tsutsugamushi and transmitted through the bite of larval forms of trombiculid mites [1]. The signs and symptoms of the disease are relatively nonspecific and in areas like Delhi where outbreaks have not been reported so far, low index of suspicion makes the diagnosis of this infection difficult. Furthermore, there is a paucity of information regarding the role of scrub typhus as a cause of fever in paediatric population. In the present study, l00 paediatric patients, 1-12years of age and presenting with febrile illness to the paediatric outpatient department or ward of a tertiary care health centre from February 2013 to March 2014 were included. Common causes of fever (malaria, dengue, enteric fever) were ruled out by history, clinical examination and appropriate laboratory investigations. In 30 patients who remained febrile and no definitive etiological diagnosis could be made, blood samples (5 ml) were collected and the serum separated and preserved at -70°C till further analysis. These samples were tested for antibodies to O. tsutsugamushi employing the immunochromatographic test (ICT), SD Bioline Tsutsugamushi Assay (Standard Diagnostics, Yongin, Korea) that employs the 56-kDa major surface protein antigens from representative O. tsutsugamushi including Gilliam, Karp, and Kato strains and detects IgG, IgM, and IgA antibodies to O. tsutsugamushi. The test was performed as per manufacturer's instructions and any positive samples further tested by an IgM ELISA (InBiOS International Inc. USA) to diagnose current infection. Among these 30 cases, ICT was positive in three (10%) samples. Further analysis of the reactive samples by IgM ELISA revealed all three samples to be IgM positive. Outbreaks of scrub typhus have been reported from various parts of India in the recent past [2,3]. Thus, there is a strong possibility of presence of this disease in this region also. All three serologically confirmed cases in the present study were residents of Delhi with no history of recent travel to a scrub typhus endemic region, a strong evidence in favour of existence of the disease in the city. The 10% prevalence of scrub typhus reported in our study is in contrast to another report from Delhi where the prevalence of scrub typhus was reported to be quiet low [4]. A study conducted in paediatric population of Sri Lanka, a region endemic for scrub typhus, has reported a prevalence of 33.33% [5]. Scrub typhus is grossly under-diagnosed due to its non-specific clinical presentation, low index of suspicion among clinicians and lack of diagnostic facilities. Since antimicrobials effective for scrub typhus are usually not included in empirical therapy for febrile illnesses, early diagnosis is imperative to reduce the mortality and complications associated with the disease. Our study highlights the existence of scrub typhus in Delhi, a region non-endemic for this infection and the need to consider it as a possible cause of paediatric febrile illnesses. To the best of our knowledge this is the first study undertaken to estimate seroprevalence of scrub typhus in paediatric population of Delhi.

Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan.

Without specific symptoms, diagnosis of febrile illness in returning travelers is challenging. Dengue, malaria, and enteric fever are common causes of fever in returning travelers and timely and appropriate treatment is important. However, differentiation is difficult without specific diagnostic tests. A retrospective study was conducted at the National Centre for Global Health and Medicine (NCGM) from April 2005 to March 2013. Febrile travelers returning from overseas who were diagnosed with dengue, malaria, or enteric fever were included in this study. Clinical characteristics and laboratory findings were compared for each diagnosis. During the study period, 86 malaria, 85 dengue, and 31 enteric fever cases were identified. The mean age of the study cohort was 33.1 ± 12 years and 134 (66.3%) study participants were male. Asia was the most common area visited by returning travelers with fevers (89% of dengue, 18.6% of malaria, and 100% of enteric fever cases), followed by Africa (1.2% of dengue and 70.9% of malaria cases). Clinical characteristics and laboratory findings were significantly different among each group with each diagnosis. Decision tree models revealed that returning from Africa and CRP levels <10 mg/L were factors specific for diagnosis of malaria and dengue fever, respectively. Clinical manifestations, simple laboratory test results, and regions of travel are helpful to distinguish between dengue, malaria, and enteric fever in febrile returning travelers with non-specific symptoms.

Scrub typhus in the northern provinces of Vietnam: an observational study of admissions to a national referral hospital.

BackgroundScrub typhus is a common cause of fever in parts of South East and Southern Asia. Little is known about the disease burden in Vietnam.MethodsA 2-year observational study of scrub typhus at a tertiary referral hospital in northern Vietnam was carried out. Diagnosis was based on a single serological test in patients with suggestive clinical symptoms.ResultsScrub typhus was diagnosed in 3.5% (251/7226) of admissions. Cases occurred throughout the year, with incidence highest in the summer. Although complications were common, mortality was low (1.2%; 3/251).ConclusionsThese data suggest that scrub typhus is common, with a seasonal distribution in northern Vietnam.

Laboratory features of common causes of fever in returned travelers.

There can be considerable overlap in the clinical presentation and laboratory features of dengue, malaria, and enteric fever, three important causes of fever in returned travelers. Routine laboratory tests including full blood examination (FBE), liver function tests (LFTs), and C-reactive protein (CRP) are frequently ordered on febrile patients, and may help differentiate between these possible diagnoses. Adult travelers returning to Australia who presented to the Royal Melbourne Hospital with confirmed diagnosis of dengue, malaria, or enteric fever between January 1, 2000 and March 1, 2013 were included in this retrospective study. Laboratory results for routine initial investigations performed within the first 2 days were extracted and analyzed. There were 304 presentations including 58 with dengue fever, 187 with malaria, and 59 with enteric fever, comprising 56% of all returned travelers with a febrile systemic illness during the study period. Significant findings included 9-fold and 21-fold odds of a normal CRP in dengue compared with malaria and enteric fever, respectively. The odds of an abnormally low white cell count (WCC) were also significantly greater in dengue versus malaria or enteric fever. Approximately one third of dengue presentations and almost half of the malaria presentations had platelet counts <100 × 10(9) /L. A normal CRP with leukopenia and/or thrombocytopenia occurred in 21% to 30% of dengue presentations, but not in malaria or enteric fever presentations. There is a wide differential diagnosis for imported fever, but the non-specific findings of a normal CRP with a low WCC and/or low platelet count may provide useful information in addition to clinical clues to suggest dengue over malaria or enteric fever. Further systematic prospective studies among travelers could help define the potential clinical utility of these results in assisting the clinician when deciding for or against commencement of empiric antimicrobial therapy while awaiting confirmatory tests.

Rapid Diagnostic Testing for Malaria

Malaria is a major public health problem in South and Central Asia. Unlike in Africa, vivax malaria — which is rarely fatal — is more common than falciparum, and viral and bacterial infections are more common causes of fever than malaria. A combination of inaccurate clinical diagnoses and poor microscopy availability has led to overdiagnosis and overtreatment. Could use of a rapid diagnostic test (RDT) that …

AB1089 Diagnosis of Systemic Inflammatory Diseases in Patients with Fever Referred to A Quick Diagnosis Unit: Experience of A Third Level Teaching Hospital in Barcelona

BackgroundQuick diagnosis units (QDUs) are an effective, useful and cost-saving model for the diagnosis of a wide range of diseases. Fever is a common symptom for multiple diseases and is...

Fever and lymphadenitis in an immunocompromised patient

Objective and importance:Bartonella henselae infections are among the most common causes of fever and lymphadenopathies, but can lead to severe complications in immunocompromised hosts; early recognition of these infections is of paramount importance in immunocompromised patients.Clinical presentation:Here we report the case of a renal transplant recipient who presented with fever, lymphadenopathies, and a splenic abscess secondary to Bartonella henselae infection, successfully treated with doxycycline.Discussion and conclusions:We discuss the various clinical presentations of Bartonella henselae infections in immunocompromised patients and the available diagnostic tools for this potentially severe complication.

Fieber bei Reiserückkehrern

Travel-related illness is most often due to gastrointestinal, febrile, and dermatologic diseases. Fever in a returned traveler demands prompt attention because it may be a manifestation of an infection that could be rapidly progressive and lethal. The approach to the febrile patient should be stepwise and consider travel and exposure history. Malaria is the most common cause of fever in patients returning from Sub-Saharan Africa, whereas dengue is more frequent in travelers from other tropical and subtropical areas. Other serious diseases are typhoid and paratyphoid fever, amebic liver abscess, visceral leishmaniasis, leptospirosis and-rarely-viral hemorrhagic fevers.

Prescribing Pattern of Anti-malarial Drugs with Particular Reference to the use of Artesunate in Complicated Plasmodium Vivax Cases.

In developing countries, Malaria has been found to be one of the most common cause of fever and morbidity, particularly among infants and young children. Therefore, its drug utilization studies should be carried out to know the rationality of treatment. To evaluate the use of antimalarial agents in children with a diagnosis of Malaria and visited to OPD & IPD Paediatric department of a tertiary care teaching hospital. This was a prospective six months study based on a Medication Utilization Form, which has been designed in consultation with the paediatrician. One hundred eighty three children <12 y of age were selected on the basis of inclusion and exclusion criteria. Out of 183 patients, 110 were infected with Plasmodium falciparum (60.10%) and 73 with Plasmodium vivax (39.89%). Most of the patients were male, 56.83% and 43.16% were female patients. Most of the complicated cases were found from Plasmodium falciparum (n = 110) than Plasmodium vivax (n=15). In prescriptions with monotherapy, Artesunate (n=101) was found to be the most commonly prescribed drug and in prescriptions containing more than one drug, Artesunate - lumefantrine (n=125) combinations were frequently used. Most of the drugs were prescribed by oral route (n=285), than the parenteral route (n=140). The average number of drugs per encounter was 2.32 and only 4.50% drugs were prescribed by generic name. Average drug cost per prescription in complicated cases was found to be higher (185.5 INR) than uncomplicated cases (115 INR). Artemisinin were used as first line drugs irrespective of the causative agent for malaria, which is not recommended, however has been found to be effective in complicated cases of Plasmodium vivax also. The cost of the prescription was higher. Interventions to rectify over prescription of injectables necessary to further improve rational drug use in our facility. Also, there should be an awareness program, especially in slum areas to cut down the transmission of disease.

Anesthetic management of an 8-month-old infant with osteogenesis imperfecta undergoing liver transplantation: a case report.

Anesthetic management of pediatric liver transplantation in a patient with osteogenesis imperfecta (OI) requires tough decisions and comprehensive considerations of the cascade of effects that may arise and the required monitoring. Total intravenous anesthesia (TIVA) with propofol and remifentanil was chosen as the main anesthetic strategy. Malignant hyperthermia (MH), skeletal fragility, anhepatic phase during liver transplantation, uncertainties of TIVA in children, and propofol infusion syndrome were considered and monitored. There were no adverse events during the operation. Despite meticulous precautions with regard to the risk of MH, there was an episode of high fever (40℃) in the ICU a few hours after the operation, which was initially feared as MH. Fortunately, MH was ruled out as the fever subsided soon after hydration and antipyretics were given. Although the delivery of supportive care and the administration of dantrolene are the core principles in the management of MH, perioperative fever does not always mean a MH in patients at risk for MH, and other common causes of fever should also be considered.

Acil servise ateş nedeni ile yapılan başvuruların değerlendirilmesi: Bir üniversite hastanesi tecrübesi

Aim. The purpose of this study is to investigate the relationship between emerging diseases with fever and the complaints of patients admitted to the hospital emergency department in North Cyprus. It is aimed to evaluate the admission complaints and etiology, who are admitted to the university hospital emergency department due to fever, from epidemiological point of view. Methods. In this retrospective study, the patients who applied to the emergency department of Medical Faculty Hospital, North Cyprus with complaints of fever between July 2010 and July 2012 were evaluated. Results. In 15,820 patients who admitted to the emergency department, 1,224 (%7.73) were found to be suffering from fever. The most common group of disease cause of fever was upper respiratory tract infections. Evaluation of other most common diseases in order to frequency were lower respiratory tract infections and gastroenteritis. Conclusions. The most common cause of fever were found to be the group of patients with a viral upper respiratory tract infections in North Cyprus. It has been identified that these data are similar to the other countries hospital emergency services.

Innovations in pneumonia diagnosis and treatment: a call to action on World Pneumonia Day, 2013.

Innovations in pneumonia diagnosis and treatment: a call to action on World Pneumonia Day, 2013.