GROUP 8

DR JAMEELA SEHRISH and others

2nd discussion forum 19th may 21st may 2023

Case:
Ahmed is a 1-year-old child brought by his mother with
complaints of fever for 3 days.
Task 1:
What are the relevant points you will ask in history from mother?
History taking.
Fever onset and duration: clarify if there are daily high temperatures and if there
has been any break in the fever (and if so, for how long – particularly important
in presentations of over 5 days of fever).
•Any recorded temperatures at home (if normothermic on presentation).
Occasionally parents will have a different idea of ‘fever’ to those clinically
recongnise
•Associated febrile symptoms: behaviour change with fever (lethargy, off
feeds/not drinking)? Improving when fever settles? Rigors? Febrile seizures?
•Anti-pyretic use and response: regular use and, if so, paracetamol, ibuprofen or
both, and at what dose? Always note the time of the last dose(s) given!
•Any focal infective symptoms?

•Rash? If so – timing in relation to fever, where did it start and any spread?

•Oral intake and urine output – dehydration

•VACCINATION HISTORY

•Birth history – particularly relevant in younger babies: Preterm?

Perinatal complications such as postnatal/intrauterine infection?
•Past medical history: any recurring infections? Immunocompromise?
(usually volunteered early by parents)
Suspicion of more severe, or more specific, aetiology may be
raised if any of the following are revealed:
•Recent travel abroad, or recent contact with traveller

•Contact with unwell individual

Family history: Inquire about any family history of recurrent fevers,

chronic illnesses, or genetic conditions that may be relevant to
current symptoms