Fever in ICU

45-year-old male – Admitted to ICU in view of Road traffic accident with multiple injuries – Injuries sustained – Moderate Traumatic brain injury – Conservatively managed – Blunt trauma chest – Right rib fractures 3rd to 5th with haemo/pneumo thorax – S/P intercostal drain placement & removal after satisfactory lung expansion – Fracture Both Bone right leg S/P Internal Fixation – Tracheostomized after day 8 of ICU stay in view of low sensorium – Currently develops – Fever -102.4 F. His vitals and labs are as follows

• GCS – E2VTM5
• Bilateral Pupil – 3to 4mm reacting
• HR – 98 per min
• BP – 140/90 mmHg
• SPO2 – 99% on Trach mask
• 2 L of O2
• No increase in Oxygen requirements
• No change in nature of tracheal secretions
• CBC – TLC – 13,000 cells with 70% Neutrophils
• Metabolic profile – Normal
• ABG – Respiratory alkalosis with normal lactate
• No A-line or CVC access
• On Condom catheter