Role of thoracic and abdominal tomography in identifying a potential
source of infection in patients with acute fever of unknown focus
Abstract
Objectives: To evaluate the relationship between clinical features
evaluated at admission to the emergency department (ED) and the presence
of infection on thoracic and abdominal tomography (CT) scans in patients
with acute febrile illness without clinical clues. Methods: Patients
aged 18 years and over who presented to ED with acute fever between
January 1, 2020 and December 31, 2020 and underwent CT imaging (thoracic
and abdomen) as a diagnostic test CT) were included in the study
retrospectively. The patients were divided into two groups according to
the presence and absence of a source of infection on CT. The clinical
and demographic data of the patients were evaluated. The effect of
clinical factors on the presence of infection in CT scans was determined
using the logistic regression analysis. Results: Among the 173 patients
included in the study, the CT scans were positive for the source of
infection in 31.2% (n=54) and negative in 68.8% (n=119). In the
multiple logistic regression analysis, age ≥ 65 years [odds ratio
(OR):2.72, 95% confidence interval (CI):1.15-4.35, p<0.001),
presence of comorbidity (OR:2.37, 95% CI:1.08-4.14, p=0.033), and
procalcitonin positivity (PCT) (OR:2.54, 95% CI:1.29-4.95, p=0.006)
were identified as risk factors for the presence of infection in CT.
Conclusion: Age, presence of comorbidity, and PCT level should be
considered when deciding on the use of CT in determining the source of
infection in acute febrile patients without clinical clues.