Fever

Question 1

What is a fever?

Answer 1

≥38°C (100.4°F) when presuming a basal body temperature of 37°C (98.6°F)

Question 2

What is hyperpyrexia

Answer 2

Elevated body temperatures, exceeding 41.5°C (>106.7°F)

Question 3

What are causes of hyperpyrexia?

Answer 3

Severe infections sometimes. Most commonly CNS injury such as stroke, hemorrhage, trauma.

Question 4

What is ANC <500 called?

Answer 4

Severe neutropenia

Question 5

How often does bacteremia cause febrile neutropenia?

Answer 5

10-25% of cases.

Question 6

What is ANC <100 called?

Answer 6

Profound neutropenia.

Question 7

Common non-infectious causes of fever [8]

Answer 7

1. Postsurgical reaction
2. DVT
3. Stroke
4. MI
5. Malignancy
6. Hemorrhage or hematoma
7. Transfusion reactions
8. Drug reaction

Question 8

What are the 3 types of FUO?

Answer 8

1. Classic
2. Nosocomial
3. Immunocompromised

Question 9

What is classic FUO?

Answer 9

Fevers of…

1. 3 weeks
2. > 38.3°C at least once.
3. Obscure etiology despite baseline work-up

Question 10

Common infectious causes of classic FUO? [9]

Answer 10

1. TB
2. Endocarditis
3. Osteomyelitis
4. Pneumonia
5. Occult abscess [abd, dental, perinephric, prostatic]
6. Sinusitis
7. Zoonoses [Q-fever, Brucellosis]
8. CMV / EBV
9. STI

Question 11

Common autoimmune causes of classic FUO? [7]?

Answer 11

1. SLE
2. Vasculitis
3. Adult-onset stills
4. Inflammatory arthritides
5. IBD
6. Sarcoid
7. Thyroiditis

Question 12

Other common causes of classic FUO?

Answer 12

1. Lymphoma/leukemia/MM
2. Solid stumors [colorectal, breast, liver, lung, testicular, kidney, bone]
3. Drugs
4. Thromboembolic
5. Congenital fever disorder.

Question 13

What is a nosocomial FUO?

Answer 13

1. Fevers >38.3°C
2. Start after hospitalization
3. Persist at least 3 days.

Question 14

Infectious causes of nosocomial FUO? [5]

Answer 14

1. Pneumonia
2. C. diff
3. Pyelonephritis
4. Device-related infections
5. Viral illness

Question 15

Non-infectious causes of nosocomial FUO? [7]

Answer 15

1. DVT / PE
2. Ischemia
3. Fat emboli
4. Bleed
5. Hematoma
6. Drugs
7. Gout
8. Transfusion reactions.