Reduced Febrile Response to Bacterial Infection in Anorexia Nervosa Patients

Objective: To report a reduced febrile response to bacterial infections in anorexia nervosa (AN) patients. Method: 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°C during the infectious illness. Discussion: 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.