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Because no reliable examination techniques predict which patients have bacteremia, hospitalized patients with fever usually undergo blood cultures, despite their low yield and high likelihood of contamination. In previous studies, researchers identified severity of chills (JAMA 2012; 308:502) and amount of food consumed just prior to the clinical event that prompted blood culture (NEJM JW Hosp Med Mar 2013 and J Hosp Med 2012; 7:702) as useful predictors of bacteremia.
In this prospective observational study, bedside nurses at three hospitals in Japan assessed 1943 consecutive patients (age range, 14–96) for shaking chills and normal food consumption (>80% of most recent meal) before blood culture collection for evaluation of fever. After ex…