Evaluation of Fever

Goal-directed point-of-care ultrasound (POCUS) is real-time, organ-focused ultrasonography performed by the clinician and it is arguably the most important contemporary extension of the physical examination for today’s clinicians. Over the past decade, POCUS has become essential in the early diagnosis and management of a critically ill patient. Goal-directed ultrasound performed by physicians is focused on clinical problems and not limited to a single anatomical area [1]. While the general goals of sonography in the unstable patient are to evaluate cardiac function and assess intravascular volume, in a patient with fever, POCUS can also help to identify the cause of the patient’s clinical condition. In addition, ultrasound guidance is essential in performing bedside procedures. The current chapter uses a case-based approach to illustrate the utility of ultrasound in making a rapid and acceptably accurate diagnosis for a patient with fever and sepsis (Figs. 37.1, 37.2, 37.3, 37.4, 37.5, 37.6, 37.7, 37.8, 37.9, 37.10, 37.11, 37.12, 37.13, 37.14, 37.15, 37.16, 37.17, 37.18, 37.19, and 37.20 and Videos 37.1, 37.2, 37.3, 37.4, 37.5, 37.6, 37.7a, 37.7b, 37.8, 37.9, 37.10, 37.11, 37.12, 37.13, 37.14, 37.15, 37.16, 37.17, 37.18, 37.19, and 37.20). Physicians caring for critical patients should strongly consider integrating focused ultrasound techniques into their routine clinical evaluation. The American College of Chest Physicians (ACCP) and the La Société de Réanimation de Langue Française (SRLF) selected a panel of experts to review the field of critical care ultrasound (CCUS) and to develop a consensus statement on competence in CCUS [3].