Reporting Dr. Maria Simbra
PITTSBURGH (KDKA) — Former President George H.W. Bush has been a patient at Houston Methodist Hospital since Nov. 23 and in the intensive care unit since Dec. 23 with a persistent fever.
“It tends to be one of the most common things that we see,” says Dr. Anil Singh, “especially in the intensive care unit.”
He came in for bronchitis, which makes infection the most likely cause.
“Once a patient gets sick enough to be in an ICU, we kind of shoot and ask questions later. We start with very big, broad spectrum antibiotics,” Dr. Singh says.
But when body temperature stays above 101 despite aggressive treatment, other reasons need to be considered. Hidden infections, cancers, inflammation and medications can cause this. For up to 15 percent of cases, a cause is never found.
“Once we find there’s not a real source, we then start kind of hunting,” Dr. Singh explains.
That could mean ultrasounds of the legs to look for clots, CT scans to look for a pocket of infection, evaluation of all I.V. lines, analyzing the blood for infection, and checking the heart valves with an ultrasound.
Other possibilities include infection with antibiotic-resistant bacteria or a primary brain problem where the body’s thermostat is set higher.
If a patient is uncomfortable, the doctors will try Tylenol, ibuprofen or cooling blankets to bring the temperature down. With persistent fever, your heart rate and breathing rate can increase and it can affect the brain with seizures, a potential concern.
“I think a lot of people forget that a fever is sometimes a good thing, in some respects,” Dr. Singh points out. “It’s a warning sign that there’s probably something wrong.”
In general, for an 88-year-old man in the ICU with fever, a lot depends on life before getting sick.
“Sometimes they do well, sometimes they don’t. And again, it depends on what their functional status is and how well they are outside of the hospital,” says Dr. Singh.