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March 1990

Nosocomial (Water Bed) Fever

Author Affiliations

Atlanta, Ga

Galveston, Tex

Arch Intern Med. 1990;150(3):687. doi:10.1001/archinte.1990.00390150153033

To the Editor. —We read with interest the article on nosocomial febrile illnesses by Filice and colleagues1 in the February 1989 issue of the Archives. Fever in the hospitalized patient with a chronic illness indeed represents a diagnostic challenge. We recently encountered an unusual cause of temperature elevation that should not be overlooked in hospitalized patients with chronic debilitating illnesses.

Report of a Case.—A 35-year-old man with severe systemic lupus erythematosus, transverse myelitis with paraplegia, and extensive decubital ulcers was admitted to our service because of high fever and hypotension. Blood cultures yielded methicillin-resistant Staphylococcus aureus organisms, and intravenous vancomycin therapy was instituted. The patient's condition promptly improved and his vital signs became normal. He was placed on a water bed for better care of the decubital ulcers.

On the seventh hospital day, the resident on call was notified that the patient's temperature was 38°C. Blood was again

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