期刊
CLINICAL MICROBIOLOGY AND INFECTION
卷 24, 期 8, 页码 808-814出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.cmi.2018.02.011
关键词
Arbovirus; Bacteraemia; Fever; Tuberculosis; Viruses; Zoonoses
资金
- University of Otago scholarship: the Frances G. Cotter Scholarship
- University of Otago scholarship: MacGibbon Travel Fellowship
- US National Institutes of Health/National Science Foundation Ecology of Infectious Disease program [R01TW009237]
- US National Institutes of Health Institute of Allergy and Infectious Disease [R01 AI121378]
- Research Councils UK
- Department for International Development (UK)
- UK Biotechnology and Biological Sciences Research Council [BB/J010367/1, BB/L018926, BB/L017679, BB/L018845]
- BBSRC [BB/J010367/1] Funding Source: UKRI
- Biotechnology and Biological Sciences Research Council [BB/J010367/1] Funding Source: researchfish
Background: Fever is among the most common symptoms of people living in Africa, and clinicians are challenged by the similar clinical features of a wide spectrum of potential aetiologies. Aim: To summarize recent studies of fever aetiology in sub-Saharan Africa focusing on causes other than malaria. Sources: A narrative literature review by searching the MEDLINE database, and recent conference abstracts. Content: Studies of multiple potential causes of fever are scarce, and for many participants the infecting organism remains unidentified, or multiple co-infecting microorganisms are identified, and establishing causation is challenging. Among ambulatory patients, self-limiting arboviral infections and viral upper respiratory infections are common, occurring in up to 60% of children attending health centres. Among hospitalized patients there is a high prevalence of potentially fatal infections requiring specific treatment. Bacterial bloodstream infection and bacterial zoonoses are major causes of fever. In recent years, the prevalence of antimicrobial resistance among bacterial isolates has increased, notably with spread of extended spectrum beta-lactamase-producing Enterobacteriaceae and fluoroquinolone-resistant Salmonella enterica. Among those with human immunodeficiency virus (HIV) infection, Mycobacterium tuberculosis bacteraemia has been confirmed in up to 34.8% of patients with sepsis, and fungal infections such as cryptococcosis and histoplasmosis remain important. Implications: Understanding the local epidemiology of fever aetiology, and the use of diagnostics including malaria and HIV rapid-diagnostic tests, guides healthcare workers in the management of patients with fever. Current challenges for clinicians include assessing which ambulatory patients require antibacterial drugs, and identifying hospitalized patients infected with organisms that are not susceptible to empiric antibacterial regimens. (c) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据