Incidence and differential characteristics of culture-negative fever following pancreas transplantation with anti-thymocyte globulin induction.
Transpl Infect Dis
; 18(5): 681-689, 2016 Oct.
Article
in En
| MEDLINE
| ID: mdl-27389917
ABSTRACT
BACKGROUND:
Limited data are available on the incidence and characteristics of culture-negative fever following pancreas transplantation (PTx) with anti-thymocyte globulin (ATG) induction. Our study aims to better define the features of culture-negative fever, so it can be delineated from infectious fever, hopefully helping clinicians to guide antibiotic therapy in this high-risk patient population.METHODS:
We performed a retrospective cohort study of postoperative fever among 198 consecutive patients undergoing PTx at our center between August 1, 2004 and December 31, 2014. Fever was classified as culture-negative if there was neither a positive culture nor a documented clinical diagnosis of infection.RESULTS:
Fever was identified in 113 patients; 66 were deemed to be infectious, 39 were culture-negative, and 8 were indeterminate. High body mass index of recipient (odds ratio 1.87, 95% confidence interval 1.15-3.03, P = 0.011) was a significant factor associated with culture-negative fever in multivariate analysis. No patients with culture-negative fever were diagnosed with infiltrates or effusion on chest radiography. In addition, an increase in white blood cell count, C-reactive protein, and serum amylase was less prominent in culture-negative fever. Culture-negative fever developed most frequently at postoperative 7 or 14 days, showing a biphasic curve.CONCLUSION:
Culture-negative fever develops in a substantial proportion of patients early after PTx. The awareness of the possibility and clinical features of post-transplant culture-negative fever might help clinicians to guide antibiotic therapy in this high-risk patient population, especially following ATG induction and early steroid withdrawal.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Immunosuppression Therapy
/
Pancreas Transplantation
/
Fever
/
Immunosuppressive Agents
/
Antilymphocyte Serum
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Transpl Infect Dis
Journal subject:
TRANSPLANTE
Year:
2016
Document type:
Article