[Chest X-ray in patients with fever and no localizing symptoms?]

Fever without localizing symptoms is a clinical problem that is frequently encountered on the emergency department. According to the NICE sepsis guideline, a chest X-ray should be considered in such patients. However, the evidence supporting this recommendation is limited to patients with neutropenic fever. We performed a telephone survey among the internists and residents at every Dutch hospital. Of the 141 physicians that responded, 88% considered a chest X-ray a valuable diagnostic tool and one that is indicated in patients with fever without localizing symptoms. In view of rising health costs, diagnostics should be chosen wisely. A clinical study on the diagnostic value of a chest X-ray in patients with fever without localizing symptoms is needed.