Acute fever
Background
Definition
- Defined as temperature ≥38°C (100.4°F).
- Peripheral temperature is not clinically accurate and central measurements are the preferred means of determining fever.[1]
- >41.0°C (105°F) needs urgent treatment (damage neurons)
Clinical Features
Differential Diagnosis
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Fever
Infectious
- Critical
- Sepsis
- PNA with respiratory failure
- Peritonitis
- Meningitis
- Cavernous Sinus Thrombosis
- Necrotizing Fasciitis
- Emergent
- PNA
- Peritonsillar Abscess
- Retropharyngeal Abscess
- Epiglottitis
- Endocarditis
- Pericarditis
- Appendicitis
- Cholecystitis
- Diverticulitis
- Intra-abdominal abscess
- Pyelonephritis
- Tubo-ovarian abscess
- Encephalitis
- Brain abscess
- Cellulitis
- Abscess
- Malaria
- Non-emergent
Non-infectious
- Critical
- Emergent
- CHF
- Dehydration
- Recent Seizure
- Sickle Cell Dz
- Transplant rejection
- Pancreatitis
- DVT
- Serotonin Syndrome
- Non-emergent
- Drug fever (except as in NMS and Serotonin Syndrome)
- Malignancy
- Gout
- Sarcoidosis
- Crohn's Disease
- Postmyocardiotomy syndrome
- Sweet's syndrome
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DDx by Heart Rate
Fever 0.55 C increases HR ~10bts/min
- Relative bradycardia
- Concomitant medication
- Drug fever
- Typhoid Fever
- Brucellosis
- Leptospirosis
- Frank bradycardia
- Rheumatic Fever
- Lyme Disease
- Viral Myocarditis
- Endocarditis
Diagnosis
See individual notes for specific workup:
- Fever and Rash
- Fever of Unknown Origin
- Neutropenic Fever
- AIDS Fever of Unknown Origin
- Heat Emergencies
- Fever in Traveler
Management
See Also
- Fever (Peds)
- FUO (Peds)
- Fever and Rash
- Fever of Unknown Origin
- Neutropenic Fever
- AIDS Fever of Unknown Origin
- Heat Emergencies
- Fever in Traveler
References
- ↑ Niven DJ, Gaudet JE, Laupland KB, Mrklas KJ, Roberts DJ, Stelfox HT. Accuracy of Peripheral Thermometers for Estimating Temperature: A Systematic Review and Meta-analysis. Ann Intern Med. 2015;163(10):768-777. doi:10.7326/M15-1150.