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October 31, 1977

Febrile Response to Whirlpool Treatments

Author Affiliations

Medical College of Pennsylvania Philadelphia

JAMA. 1977;238(18):1912. doi:10.1001/jama.1977.03280190014006

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To the Editor.—  We have seen a patient who experienced a transient febrile response to whirlpool bath treatments without proved bacteremia. To our knowledge, this represents a first reported case of this phenomenon. Whirlpool is a widely used mode of debridement and cleansing for extensive burns and devitalized tissue.

Report of a Case. —  A 25-year-old woman had an automobile accident and sustained bilateral open tibial and fibular fractures with large areas of both lower extremities denuded of skin and muscle. Wide debridement of devitalized tissue was done, and skeletal stabilization of fractures was obtained with rodding on the left and bilateral calcaneal traction. Over several days the patient's condition stabilized, but a left, above-knee amputation was necessary because of extensive tissue necrosis.The patient recovered well, and whirlpool therapy twice daily was instituted in hopes of adequately debriding the remaining limb. Whirlpool was done with warm water and povidone-iodine