{"doi":"10.1093/cid/ciae118","title":"Society of Critical Care Medicine/Infectious Diseases Society of America (SCCM/IDSA) New Fever Guideline","abstract":"To the Editor—The Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA) have updated their guideline for the evaluation of new-onset fever in adult intensive care unit (ICU) patients without severe immunocompromise [1]. The update now incorporates the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. We are writing to share some top-line recommendations from these updated guidelines with Clinical Infectious Diseases readers. The updated guideline addresses the use of microbiologic studies, imaging procedures, and biomarkers in the initial diagnostic evaluation of new-onset fever, with a focus on the detection of potential infectious etiologies. Although much of this document and its recommendations are applicable to severely immunocompromised patients, such as organ transplant recipients and those with severe neutropenia, these populations are not directly addressed here. Fever is a frequent finding in ICU patients. While having many potential causes, it is often an early sign of infection, the rapid recognition and management of which may be critical to favorable outcomes. It must also be recognized that infection may, however, be present in the absence of fever. Fever, itself, should not be a routine target for antipyretic administration. This guideline does not address severely immunocompromised patients with new-onset fever, but the principles outlined here generally apply to them as well. Imaging is an important element of patient evaluation. While comparative clinical data are absent, in the absence of an obvious non-thoracic source of infection, all patients should undergo chest radiography. In addition to routine microbiologic studies, biomarkers are discussed and consideration is given to the use of rapid molecular tests for the diagnosis of respiratory tract infections, including coronavirus disease 2019 (COVID-19). Recommendations are provided for the diagnosis of central venous access device infections. Site-specific computed tomography should be performed in patients who have recently undergone thoracic, abdominal, or pelvic surgery and may be considered in others with clinical findings pointing to these sites. In patients with persisting fever for whom initial investigations fail to reveal a source, either usual care or 18F-fluorodeoxyglucose positron emission tomography may be considered. For additional information, please review the Supplementary Materials, which outline key recommendations from the updated SCCM-IDSA guidelines. Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author.","journal":"Clinical Infectious Diseases","year":2024,"id":494937,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9309,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":904649,"name":"Naomi P. O’Grady","orcid":null,"position":1,"is_corresponding":false},{"id":691714,"name":"Stanley C. Deresinski","orcid":null,"position":0,"is_corresponding":true}],"reference_count":1,"raw_metadata":null,"created_at":"2026-07-19T02:09:15.528853Z","pmid":"38441985","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}