Fever Work-up (1)

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Admission for possible sepsis or Inpatient with temp ≥39, clinical signs of sepsis, and >48 hours since last culture

• Examine patient for obvious source of infection
• Blood cultures x 2. Obtain both cultures from 2 different peripheral sites. If bacteremic, repeat blood cultures every 48 hours (peripherals from 2 sites) until clear
• Urine analysis with reflex urine culture
• BAL quantitative culture if intubated. Consider mini-BAL if unable to complete formal bronchoscopy.
• Quantitative wound biopsy if large open wound/burn
• Evaluate other possible sites for infection:
  • IV and line sites
  • Operative wounds
  • Pressure ulcer sites
  • DVT
  • Intraabdominal abscess
  • Sinusitis
  • Drug fever