Adult patients with occult bacteremia discharged from the emergency department: Epidemiological and clinical characteristics

To determine the epidemiological and clinical characteristics of patients w ho were discharged from the emergency department (ED) and subsequently prov ed to have bacteremia, we prospectively assessed all patients examined in t he ED during an 18-month period from whose blood cultures a significant org anism was isolated. Discharged patients were contacted and reevaluated. Two case-control studies were conducted, in which each study patient was match ed with a total of 4 control patients. During the study period, 46,336 pati ents were examined in the ED; 78% were adults and 22% were children. Blood cultures were performed for 25% of the adult patients and for 44% of the ch ildren. Although the occurrence of occult bacteremia in patients who were d ischarged from the ED is 3.7 times more common in children than in adults, the absolute numbers of discharged adults and children with occult bacterem ia are similar. Careful clinical assessment will not prevent discharge of s ome of these patients; however, these patients in general do well and can b e safely recalled for reevaluation and complementation of therapy.