الفهرس 
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Abstract
In humans, body temperature is regulated at the hypothalamus region of the brain which regulates body temperature to function within + o.5oc of resting temperature over each 24 hour cycle. Fever is a cytokine-regulated elevation of core body temperature above normal. IDSA recommend that any new fever in an ICU patient should be investigated only if the temperature is 38.3oc (101oF) or higher. Conventional means of measuring temperature in ICU patients include intravascular, intravesical, rectal, oral, tympanic and cutaneous. Each has advantages and disadvantages. Because fever can have many infectious and non infectious etiologies, a new fever in ICU patient should trigger a careful clinical assessment rather autonomic order for laboratory and radiologic tests. A cost-conscious approach to obtain cultures and imaging studies should be undertaken if indicated after a clinical evaluation. Regarding the infectious causes, pneumonia, urinary tract infection (UTI), blood stream infection (BSI), surgical site infection (SSI), gastrointestinal tract (GIT) and central nervous system (CNS) infections are frequently common. Pneumonia occurs especially in patients who are mechanically ventilated (ventilation-associated pneumonia, VAP) with the incidence of pneumonia increase with increased duration of ventilation. Urinary tract infection is common in patients with indwelling bladder catheters especially when used for long duration with each day of catheter use is associated with an approximately 5% increase in bacteriuria. However, it is likely that most of these patients had asymptomatic bacterieuria rather than true infection of the urinary tract. Bloodstream infection classified as a more frequent primary type usually results from intravascular devices, more commonly CVC, especially with prolonged duration of catheterization, prolonged hospitalization before catheterization and with the more number of manipulations. CVC via the femoral and internal jugular veins have a similar infection rates which are higher than that for catheters inserted via the subclavian approach. Surgical site infection, a major source of illness to a surgery patient, is influenced by a number of risk factors including patient’s factor, anaethetic factors, wound status and surgeon-related factors. Gastrointestinal tract infection occurs mostly due to C-difficile in patients with antibiotic-resistant diarrhea. Although CNS infection is an uncommon primary nosocomial infection, Meningitis is mostly occur secondary to neurosurgical procedure or head trauma and occasionally bacteremia. Non-infectious causes of fever include drug fever, blood transfusion, post-operative stress and ischemic cerebral damage. After this review of literature about fever in ICU patients it can be concluded that assesment of fever requires careful history taking, medication review and a through physical examination of all major body system. Although many if not causes of fever are related to infectious, non-infectious causes of fever are present. While the temperature is great to treat febrile patients with antibiotic, this approach cannot be effective in patients with non-bacterial infection or non infectious causes of fever. The main diagnostic dilemma is to exclude non-infectious causes of fever to determine the site and likely pathogens of those infections.