Epidemiology of febrile diseases in the emergency department of a Caribbean island: the Curaçao experience.
OBJECTIVE
The aetiology of febrile diseases in tropical countries often remains poorly characterized. We aim to describe the aetiology and outcome of febrile illnesses at the Emergency Department (ED) in Curaçao.


METHODS
From April 2008 - April 2009, all adult febrile patients (T> 38.5 degrees C) at the ED of the St Elisabeth Hospital, Curaçao, Netherlands Antilles, were included. Clinical data were recorded, routine laboratory measurements and blood cultures were taken. Final diagnoses were made at discharge by an independent physician and in retrospect by the main investigator


RESULTS
Four hundred and three patients were included: 223 patients (55.6%) were hospitalized, 32 patients (7.9%) died and 18 patients (4.5%) were admitted to the Intensive Care Unit. In 129 febrile patients (32.0%), infection was proven; 84.4% of patients had bacterial (29.0% urinary tract infection, 23.2% pneumonia infection), 5.6% viral and 10.0% parasitic or fungal infections. Twenty-one patients (5.2%) were discharged with a non-infectious diagnosis and 172 patients (42.7%) without a clear diagnosis.


CONCLUSIONS
A high mortality rate of 7.9% was observed. We found a high prevalence of bacterial infections, with pneumonia and urinary tract infections as the most common causes of fever. One in 20 patients did not have an infectious disease.
Slotervaart Hospital, Department of Internal Medicine, Louwesweg 6, 1066 EC Amsterdam, The Netherlands. maarten.limper@slz.nl
M
M
Limper
I
I
Gerstenbluth
A J
AJ
Duits
E C M
EC
van Gorp
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications; D009369:Neoplasms / Q000150:complications; D009427:Netherlands Antilles / Q000453:epidemiology; D010272:Parasitic Diseases / Q000150:complications; D014777:Virus Diseases / Q000150:complications