Acute fever: Difference between revisions
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===Definition=== | ===Definition=== | ||
*Defined as [[Celsius Fahrenheit Temperature Conversion|temperature]] ≥38°C (100.4°F). | *Defined as [[Celsius Fahrenheit Temperature Conversion|temperature]] ≥38°C (100.4°F). | ||
*Peripheral temperature is not clinically accurate and central measurements are the preferred means of determining fever.<ref>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.</ref> | *Peripheral temperature is not clinically accurate and central measurements are the preferred means of determining fever. | ||
**Rectal or oral | |||
**Rectal temperatures should not be performed in neutropenic patients<ref>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.</ref> | |||
==Clinical Features== | ==Clinical Features== | ||
*Fever directly causes an increase in:<ref>Davies P, Maconochie I. The relationship between body temperature, heart rate and respiratory rate in children. Emerg Med J. 2009 Sep;26(9):641-3. doi: 10.1136/emj.2008.061598.</ref> | |||
**Heart rate: 10 beats per minute per degree centigrade | |||
**Respiratory rate | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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===DDx by Heart Rate=== | ===DDx by Heart Rate=== | ||
''Every 0.55°C increase in temperature should → increase HR by ~10BPM | |||
*If patient has relative bradycardia, consider: | |||
**Concomitant medication | |||
**Drug fever | |||
**[[Typhoid Fever]] | |||
**Brucellosis | |||
**[[Leptospirosis]] | |||
*If patient has frank bradycardia, consider: | |||
**[[Rheumatic Fever]] | |||
**[[Lyme Disease]] | |||
**Viral Myocarditis | |||
**[[Endocarditis]] | |||
== | ==Evaluation== | ||
See individual notes for specific workup: | See individual notes for specific workup: | ||
*[[Fever and Rash]] | *[[Fever and Rash]] | ||
| Line 34: | Line 38: | ||
==Management== | ==Management== | ||
*Consider [[tylenol]] or [[ibuprophen]] for fever relief | |||
*Treat the underlying condition | |||
==Disposition== | |||
*Depends on underlying etiology | |||
==See Also== | ==See Also== | ||
*[[ | *[[Pediatric fever of uncertain source]] | ||
*[[Fever and rash]] | |||
*[[Fever and | *[[Fever of unknown origin]] | ||
*[[Fever of | *[[Neutropenic fever]] | ||
*[[Neutropenic | *[[AIDS fever of unknown origin]] | ||
*[[AIDS | *[[Environmental heat diagnoses]] | ||
*[[ | *[[Fever in traveler]] | ||
*[[Fever in | |||
==References== | ==References== | ||
<references/> | |||
[[Category:ID]] | [[Category:ID]] | ||
Latest revision as of 22:16, 29 April 2020
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.
- Rectal or oral
- Rectal temperatures should not be performed in neutropenic patients[1]
Clinical Features
- Fever directly causes an increase in:[2]
- Heart rate: 10 beats per minute per degree centigrade
- Respiratory rate
Differential Diagnosis
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
DDx by Heart Rate
Every 0.55°C increase in temperature should → increase HR by ~10BPM
- If patient has relative bradycardia, consider:
- Concomitant medication
- Drug fever
- Typhoid Fever
- Brucellosis
- Leptospirosis
- If patient has frank bradycardia, consider:
- Rheumatic Fever
- Lyme Disease
- Viral Myocarditis
- Endocarditis
Evaluation
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
- Consider tylenol or ibuprophen for fever relief
- Treat the underlying condition
Disposition
- Depends on underlying etiology
See Also
- Pediatric fever of uncertain source
- Fever and rash
- Fever of unknown origin
- Neutropenic fever
- AIDS fever of unknown origin
- Environmental heat diagnoses
- 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.
- ↑ Davies P, Maconochie I. The relationship between body temperature, heart rate and respiratory rate in children. Emerg Med J. 2009 Sep;26(9):641-3. doi: 10.1136/emj.2008.061598.