IM Essentials: Ch. 55 - Approach to Fever

Question 1

List five cytokines that regulate fever.

Answer 1

• IL1
• IL6
• TNFa
• PGE2
• Interferons

Question 2

What is coryza?

Answer 2

Inflammation of the nasal mucosa

Question 3

Review some localizing cues for fever.

Answer 3

Cough, coryza, dyspnea, dysuria, diarrhea, localized pain, wounds, rash, unusual discharge, history of recent medical interventions, or instrumentation

Question 4

What are some common causes of FUO without a noticeable cause?

Answer 4

• Vertebral osteomyelitis
• Malignancy (particularly lymphoma as it can have a normal CBC)
• Intra-abdominal abscess
• Endocarditis

Question 5

Discuss the prognosis of FUO.

Answer 5

Despite exhaustive workups, up to 1/3 of patients with FUO do not have an identified diagnosis. Almost all resolve, though.