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  • Fever with unknown source

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    luisa gonzález
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    This document provides a clinical guideline for evaluating and managing a patient presenting with fever of unknown source. It outlines a step-by-step approach including: 1) assessing for sepsis and risk factors that require immediate attention, 2) obtaining a thorough medical history and physical examination focusing on areas that may localize the source of infection, and 3) ordering appropriate laboratory and imaging investigations based on exam findings. The guideline emphasizes continuous reassessment of the patient and treatment or admission decisions based on clinical stability and presence of concerning factors.

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    Original Title

    Algoritmo Fiebre de Origen Desconocido

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    This document provides a clinical guideline for evaluating and managing a patient presenting with fever of unknown source. It outlines a step-by-step approach including: 1) assessing for sepsis and risk factors that require immediate attention, 2) obtaining a thorough medical history and physical examination focusing on areas that may localize the source of infection, and 3) ordering appropriate laboratory and imaging investigations based on exam findings. The guideline emphasizes continuous reassessment of the patient and treatment or admission decisions based on clinical stability and presence of concerning factors.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    10 views1 page

    Fever with unknown source

    Uploaded by

    luisa gonzález
    This document provides a clinical guideline for evaluating and managing a patient presenting with fever of unknown source. It outlines a step-by-step approach including: 1) assessing for sepsis and risk factors that require immediate attention, 2) obtaining a thorough medical history and physical examination focusing on areas that may localize the source of infection, and 3) ordering appropriate laboratory and imaging investigations based on exam findings. The guideline emphasizes continuous reassessment of the patient and treatment or admission decisions based on clinical stability and presence of concerning factors.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    Fever with unknown source

    No SEPSIS? Yes
    Click here for SEPSIS PATHWAY See Adult Sepsis Toolkit
    FLOWCHART

    No

    RISK FACTORS?
    • Immunocompromised (HIV, diabetes, steroid therapy)
    Yes
    • Known malignancy (recent chemotherapy +/- neutropenia)
    • Intravenous drug user
    • Elderly
    Continuous • Pregnancy
    repeated
    No
    assessment
    with ASSESSMENT
    thorough HISTORY EXAMINATION* INVESTIGATIONS
    history and Past medical history General Blood tests
    Known malignancy Skin for rashes, animal FBC with differential
    physical Previously treated bites Serum biochemistry (EUC,
    diseases such as Nail bed exam for LFTs)
    examination
    endocarditis, clubbing, nodules, lesions ESR
    for localising tuberculosis, rheumatic Subconjunctival Blood culture  WCC
    fever haemorrhage Others to consider: HIV
    signs Comorbid conditions (eg. Uveitis antibody, CMV IgM, Q
    Consider
    diabetes) Palpate for fever serology, Hepatitis admission
    lymphadenopathy serology  Hb LOW
    Yes Past surgical history Cardiovascular Urine m/c/s THRESHOLD
    Type and date of surgery Temporal artery palpation
    Postoperative Auscultation for bruits and
    FOR
    Markedly ADMISSION
    complications murmurs
    Treat and abnormal
    Any indwelling foreign
    material examination /
    assess investigation
    Medication history Gastrointestinal Chest x-ray
    appropriately Full list of medications Gums and oral cavity finding
    Include over-the-counter Abdominal palpation for
    and herbal remedies hepatosplenomegaly
    Yes Social history Genito-urinary Additional investigations as
    Recent travel history Rectal examination for indicated by
    Sexual history including abscesses history/examination
    Treat and
    sexual practices Testicular examination findings assess
    Recreational drug use e.g. Thick/thin films
    RED FLAGS Hobbies including CT/US abdomen appropriately
    exposure to pets/animals Echocardiography
    Infective endocarditis Employment history Lumbar puncture
    Tuberculosis including exposures Joint aspirate
    HIV Unusual dietary habits Doppler lower limbs
    Neurological
    Osteomyelitis Altered mentation
    Rheumatic fever Focal neurologic signs
    Malignancy Musculoskeletal
    Bony tenderness
    Giant cell arteritis Joint effusion
    *Focussing on areas of high diagnostic yield. Full systems review is a minimum requirement.

    No Consider causes
    Click here for a
    summary table of
    common causes

    Can be discharged CLINICALLY STABLE? Admit for further


    home with plan for Yes • Normal vital signs No
    • Normal level of consciousness investigation and
    timelytext]
    [Type follow-up and • No other concerning factors management
    review

    This clinical guideline is intended for use with adult patients. For information regarding assessment of fever in the paediatric patient populations, please refer here.

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