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
''Every 0.55°C increase in temperature should → increase HR by ~10BPM
#Relative bradycardia
*If patient has relative bradycardia, consider:
## Concomitant medication
**Concomitant medication
## Drug fever
**Drug fever
## [[Typhoid Fever]]
**[[Typhoid Fever]]
## Brucellosis
**Brucellosis
## [[Leptospirosis]]
**[[Leptospirosis]]
#Frank bradycardia
*If patient has frank bradycardia, consider:
## [[Rheumatic Fever]]
**[[Rheumatic Fever]]
## [[Lyme Disease]]
**[[Lyme Disease]]
## Viral Myocarditis
**Viral Myocarditis
## [[Endocarditis]]
**[[Endocarditis]]


==Diagnosis==
==Evaluation==
See individual notes for specific workup:
See individual notes for specific workup:
*[[Fever and Rash]]
*[[Fever and Rash]]
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==Management==
==Management==
*Consider [[tylenol]] or [[ibuprophen]] for fever relief
*Treat the underlying condition


==Disposition==
*Depends on underlying etiology


==See Also==
==See Also==

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

Non-infectious

DDx by Heart Rate

Every 0.55°C increase in temperature should → increase HR by ~10BPM

Evaluation

See individual notes for specific workup:

Management

Disposition

  • Depends on underlying etiology

See Also

References

  1. 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.
  2. 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.