Management of Acute Febrile Illness

Initial Assessment and Diagnosis

• The American Thoracic Society recommends monitoring vital signs including temperature, respiratory rate, pulse, blood pressure, mental status, and oxygen saturation at least twice daily in patients with acute febrile illness 1, 3
• Consider hospital admission if the patient has two or more unstable clinical factors: temperature >37.8°C, heart rate >100/min, respiratory rate >24/min, systolic blood pressure <90 mmHg, or oxygen saturation <90% 1, 4

Treatment Algorithm

• The British Thoracic Society recommends antiviral therapy (oseltamivir) for influenza-like illness within 48 hours of symptom onset, and antibiotics only indicated for specific bacterial complications or high-risk patients 1, 2, 3
• Previously well adults with acute bronchitis complicating influenza do not routinely require antibiotics, but consider antibiotics if symptoms are worsening or patient is at high risk of complications 1, 2, 5

Supportive Care

• Ensure adequate hydration and nutritional support, especially in severe or prolonged illness, as recommended by the American College of Physicians 1, 3
• Provide supplemental oxygen if oxygen saturation falls below 90% 3

Follow-up Care

• Review patients 24 hours prior to discharge, and consider follow-up clinical review for all patients who suffered significant complications or worsening of underlying disease 1, 3