Fever

HPI

 About the fever

 Daily / every few days?
 Associated symptoms:
o Cough / pleuritic chest pain / dyspnoea
o Abdominal pain, diarrhea
o Dysuria

Medical / surgical Hx

 DM ?
o Risk of TB, myliadosis
 Liver disease
 Autoimmune disease
 Surgical procedure

Misc

 Travel
 Sexual
 Recreation
 Medication

Tests:

 Blood film,
 Blood culture
 Chest X-ray?

Note: bacteremia precedes fever by 20-30 mins.

Indication for blood culture

 Suspected or proven infection

 Febrile patient
 Afebrile bacteremia
o Geriatric patient
o Immunosuppressed patient: pt on steroids
o Disruption to hypothalamus
o hypothyroidism