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Master Thesis

Consultation de l’adulte pour fièvre aux urgences de Cayenne : nosographie et devenir du patient

Abstract : Background: Fever is a major presentation symptom at Emergency Departments (EDs). The epidemiology of febrile patients at the EDs of French Guiana remains poorly described. The objectives of this study were to describe the profile of adult patients presenting with fever at the ED of Cayenne, and then to analyze diagnosis and outcome. Methods: This descriptive, retrospective, monocentric study was conducted at the AndréeRosemon of Cayenne’s Hospital, from 01/10/2016 to 30/03/2017. We included all adult patients (≥ 18 years) presenting at the ED for the symptom "fever" and/or with measured temperature≥ 38°C at the admission. Results: A total of 835 consultations for fever were analyzed, representing 6.5% of all admissions at the ED of Cayenne over the period. The patients were in median 41 years old [IQR, 29-60] and lived mostly (83.4%) on Cayenne’s island. The most common diagnosis was low respiratory infection (16.6%), followed by viral infections (15.7%), fevers without identified etiology (11.3%), digestive or hepatobiliary infections (10.7%) and urinary tract infections (9.9%). Malaria was diagnosed in 1.7% of the patients. After ED discharge, 529 patients (63.3%) returned at home, 284 (34.0%) were hospitalized and discharged alive after a median of 8 days [IQR,4-16], and 22 (2.6%) died. In patients with unknown HIV status, a diagnostic test was performed in 21.0% of outpatients, 52.9% of hospitalized patients, and 50.0% of the patients who died. Conclusion: This study highlighted the particularly young profile of the patients compared to other studies with similar design, the predominance of low respiratory infections, the important decrease in the number of malaria diagnoses since the last survey conducted in 2003, and the too low HIV screening rate regardingto the local epidemiological specificities. Taking these results into account should allow optimizing the management of Guiana patients and also the medical advice to travelers.
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Master Thesis
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Valérie Leroux. Consultation de l’adulte pour fièvre aux urgences de Cayenne : nosographie et devenir du patient. Médecine humaine et pathologie. 2018. ⟨dumas-02463101⟩

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