Reduced febrile response to bacterial infection in anorexia nervosa patients.
OBJECTIVE
To report a reduced febrile response to bacterial infections in anorexia nervosa (AN) patients.


METHODS
Four cases were obtained from a retrospective review of charts from the St. Paul's Hospital Eating Disorders Program (Vancouver, Canada). The patients had died or had been admitted to the hospital for treatment of a bacterial infection. In addition, one case was obtained from the Royal Prince Alfred Hospital (Sydney, Australia).


RESULTS
All patients suffered a bacterial infection during the course of AN. None of the patients had a temperature higher than 37 degrees C during the infectious illness.


CONCLUSIONS
The absence of fever in AN may delay the diagnosis of bacterial infection and may be a marker of an impaired immune response. Therefore, alternative methods of investigation are necessary in patients with AN suspected of having a bacterial infection.
Birmingham
C Laird
CL
Eating Disorders Program, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada. clbirm@interchange.ubc.ca
Hodgson
Deborah M
DM
Fung
Jonathan
J
Brown
Rhonda
R
Wakefield
Alison
A
Bartrop
Roger
R
Beumont
Pierre
P
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000276:immunology*; D001424:Bacterial Infections / Q000175:diagnosis / Q000276:immunology*; D001833:Body Temperature Regulation / Q000276:immunology; D001835:Body Weight / Q000502:physiology; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology; D010343:Patient Admission; D012189:Retrospective Studies; D012307:Risk Factors