- CC:
- Documentation of the fever: route of measurement? Readings? Frequency?
- Onset: when? Frist time? Sudden\gradual? Intermittent\continuous? Getting better\worse?
- Time: specific time of day? More at night?
- Aggravating\relieving factors: antipyretics?
- Severity: affecting ADL?
- Associated sx:
- Constitutional: fever, wt loss, loss of appetite, night sweats, chills?
- CNS: headache, photophobia, stiff neck, confusion?
- Resp: chest pain, cough\sputum, hemoptysis, ENT Sx?
- GI: N\V, diarrhea, abdominal pain, jaundice?
- GU: dysuria, hematuria, vaginal discharge?
- Rhemua: joint pain, muscle aches, rash?
- PMHx:
- Diseases:
- Chronic ds (HTN, DM, DLP)
- Infections (HIV)
- Autoimmune ds
- Malignancy
- Medications: steroids, abx, chemo
- Surgery (transplant, dental, urine cath), hospitalization, trauma
- Blood transfusions, IV drug use, tattoos
- Allergies
- Diseases:
- FMHx:
- Similar complaint?
- Same diseases as in PMHx?
- Social Hx:
- Occupation, marital status, children?
- Smoking, alcohol, recreational drugs?
- Travel Hx, contact with sick pts\animals?
- Where? Duration?
- Activities: accommodation? Hiking? Diet? Sexual contact?
- Vaccinations? Anti-malarial prophylaxis?
- Diet (raw milk), exercise
- Definition of Fever of Unknown Origin (FUO)?
- Classic FUO:
- ≥ 38.3° C
- ≥ 3 weeks
- Measure in 3 outpatient visits or 3 inpatient days
- Classic FUO:
- DDx of FUO?
- Infections: TB, CMV, EBV
- Malignancy: lymphoma, leukemia, RCC
- Vasculitis\connective tissue ds: still’s ds
- Drug fever
- Factitious fever
- Definition of SIRS?
- Two or more of:
- Fever or hypothermia
- Hyperventilation or PaO2 < 32
- Tachycardia
- High WBC (> 12,000)
- Two or more of: