title: Reduced febrile response to bacterial infection in anorexia nervosa patients.
abstract: 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.
authors.affiliation: Eating Disorders Program, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada. clbirm@interchange.ubc.ca
authors.forename: C Laird
authors.initials: CL
authors.lastname: Birmingham
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Hodgson
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fung
authors.forename: Rhonda
authors.initials: R
authors.lastname: Brown
authors.forename: Alison
authors.initials: A
authors.lastname: Wakefield
authors.forename: Roger
authors.initials: R
authors.lastname: Bartrop
authors.forename: Pierre
authors.initials: P
authors.lastname: Beumont
mesh_terms: 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