FEVER & FUO

Question 1

• Temperature of rectal
• hyperpyrexia

Answer 1

• > =38°C
• > 40°C

Question 2

• highest point of fever is reached in
• lowest point of fever is reached in the

Answer 2

• early evening
• the morning

Question 3

• temperature elevation is present only for a certain period, later cycling back to normal
• malaria, leishmaniasis, pyemia, or sepsis

Answer 3

Intermittent fever

Question 4

• temperature remains above normal throughout the day and does not fluctuate more than 0.5°C in 24 hours
• Drug fever, typhoid, Neoplasms

Answer 4

Sustained/Continuous fever

Question 5

• temperature remains above normal throughout the day and fluctuates more than 0.5 °C in 24 hours - infective endocarditis, or brucellosis

Answer 5

Remittent fever

Question 6

• Episodes of fever recurring at regular intervals
• Quotidian fever (24-hour periodicity ):
  > P. knowlesi
• Tertian (48 hour periodicity): Risrier
  > P. vivax, PR. ovale
• Quartan (72 hour periodicity):
  > P malariae

Answer 6

Periodic or Cyclic Fever

Question 7

• indicates a single illness with 2 distinct periods
  (camelback fever pattern)
• poliomyelitis is the classic example

Answer 7

Relapsing fever: Biphasic fever

Question 8

Fever of acute onset, with duration of <1 wk and without localizing signs, is a common
diagnostic dilemma in children

Answer 8

<36 mo of age

Question 9

Fever of Unknown Origin is documented when

Answer 9

• for which the cause could not be identified
  after 3 wk of evaluation as an outpatient or
• after 1 wk of evaluation in the hospital

Question 10

FUO Common Causes by Age Group

• 1-5 yrs
• 5-10 yrs
• > 10 yrs

Answer 10

• 1-5 yrs - common causes are RTI, UTI, diarrhoea and osteomyelitis
• 5-10 yrs-measles, mumps, chicken pox, typhoid
  -10yrs- TB, typhoid ,rheumatic fever

Question 11

FUO based on Onset

• Acute

Answer 11

1.Measles
2. Mumps
3.Acute sinusitis

Question 12

FUO based on Onset

• Insidious

Answer 12

1. Thypoid
2. Malignancies

Question 13

FUO based on Grade of Fever

• Low grade
• High Grade

Answer 13

• LOW
  1.TB
  2.HIV
  3.Sinusitis
  4.Diptheria.
• HIGH
  1.Dengue
  2. Malaria
  3.typhoid

Question 14

FUO based on Duration

• short

Answer 14

1. malaria
2. Dengue
3. measles
4. varicella

Question 15

FUO based on Duration

• long

Answer 15

1. Brucellosis
2. malignancies
3. Rheumatic fever

Question 16

FUO based on Progression

Answer 16

• Viral fever peaks in 2 days and declines
• Bacterial fever worsens day by day without treatment
• Parasite fever like malaria shows cyclical cold,hot and sweating stages.

Question 17

FUO based on Type

• Continuous-
• Remittent
• Intermittent -
• Step ladder fever-

Answer 17

• Continuous-Pneumonia ,uti
• Remittent-Viral, collagen vascular diseases
• Intermittent - Malaria , Brucellosis
• Step ladder fever-Typhoid

Question 18

Feature of Classic FUO

• Temperature: >/=38.0°C
• Duration of evaluation & fever:
  + >3 weeks as outpx
  + >1 week as inpx
• Lab: HIV infection confirmed
• Causes:
  + HIV primary infection
  + Typical and atypical Mycobacteria
  + CMV
  + Lymphoma
  + Toxoplasmoids
  + Cyptococcosis
  + Immune reconstitution inflammatory syndrome (IRIS)

Answer 18

HIV-related FUO

Question 19

Feature of Classic FUO

• Temperature: >/=38.0°C
• Duration of evaluation & fever:
  + >1 week
• Lab: (-) CULTURES AFTER 48hrs
• Causes:
  + Majority are caused by infections, documented only in 40-60%

Answer 19

Immune-Deficient FUO

Question 20

Feature of Classic FUO

• Temperature: >/=38.0°C
• Duration of evaluation & fever:
  + >1 week
• Lab: Not present or incubating on admission
• Causes:
  + Healthcare-associated infections
  + Postoperative complications
  + Drug fever

Answer 20

Healthcare-associated FUO

Question 21

Feature of Classic FUO

• Temperature: >/=38.0°C
• Duration of evaluation & fever:
  + >3 weeks as outpatient
  + > 2 visits
  + >1 week as inpx
• Lab: None
• Causes:
  + Cancer
  + Infections
  + Inflammation
  + Hyperthermia
  + Undiagnosed

Answer 21

Classic FUO