A prospective investigation of immunosuppressed patients appli̇ed for high fever complai̇nt

INTRODUCTION AND AIM: The diagnosis and treatment of immunosuppressed patients are delayed because of the inability to create an adequate immune response and their admission to the emergency department with atypical complaints. Rapid and appropriate management of immunosuppressed patients in emergency services with high patient density is very important. The main purpose of our study; to reveal the relationship between the examinations performed at the time of admission to the emergency department of this patient group and the patients' early diagnosis, prognosis, mortality and hospitalization status. MATERIALS AND METHODS: Eighty immunosuppressed patients who were admitted to the adult emergency department with high fever between May 2019 and May 2020 were prospectively studied. While patients older than 18 years of age were included in the study, healthy individuals without fever complaints, who were not immunosuppressed and were excluded from the study. An examination form was created for immunosuppressed patients who presented with high fever and filled out for each patient. RESULTS: In the gender analysis of 80 patients included in the study; 44 (55%) were female, 36 (45%) were male and the mean age was 58.50 ± 14.72 years. We found that there was a significant relationship between the length of stay of the patients and the CRP and TIT WBC values. We found that low albumin, O2 saturation, PLT, total protein values and high lipase, PCT values were associated with mortality in our patients. We found that low albumin, total protein, systolic blood pressure and high blood urea nitrogen, lactate dehydrogenase, neutrophil, procalcitonin levels were associated with intensive care admission in our patients. When we examine the last diagnoses of our patients according to their immunosuppression status; we found that most of the patients with liver transplantation were diagnosed with cholangitis, most of the patients with malignancy had respiratory system infection, and most of the patients with kidney transplantation had urinary tract infection. CONCLUSION: Immunosuppressed patients admitted to the emergency department with high fever should be taken seriously, even if they do not have high fever. In addition, appropriate examinations to be made at the time of admission to these patients are of vital importance in terms of clinical course. KEYWORDS: Fever, Immunosuppression, Transplantation