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===Fever patterns and their clinical significance===
===Fever patterns and their clinical significance===
The pattern of fever generally offers little diagnostic value in ascertaining the etiology of fever. Characteristic fever patterns include:<ref>{{cite book | last = Isaac | first = Benedict | title = Unexplained fever : a guide to the diagnosis and management of febrile states in medicine, surgery, pediatrics, and subspecialties | publisher = CRC Press | location = Boca Raton | year = 1991 | isbn = 9780849345562 }}</ref>
The periodicity of fever generally offers little diagnostic value in ascertaining the etiology of fever. Characteristic fever patterns include:<ref>{{cite book | last = Isaac | first = Benedict | title = Unexplained fever : a guide to the diagnosis and management of febrile states in medicine, surgery, pediatrics, and subspecialties | publisher = CRC Press | location = Boca Raton | year = 1991 | isbn = 9780849345562 }}</ref>
* Sustained fever (suggestive of [[brucellosis]], [[drug fever]], [[lobar pneumonia]], [[tularemia]], [[typhoid]], [[typhus]])
* Sustained fever (suggestive of [[brucellosis]], [[drug fever]], [[lobar pneumonia]], [[tularemia]], [[typhoid]], [[typhus]])
* Remittent fever (suggestive of [[tuberculosis]], [[mycoplasma pneumonia]], [[malaria]], [[legionellosis]])
* Remittent fever (suggestive of [[tuberculosis]], [[mycoplasma pneumonia]], [[malaria]], [[legionellosis]])
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* Hyperpyrexia (suggestive of [[intracranial hemorrhage]], [[septicemia]], [[Kawasaki disease]], [[thyroid storm]], [[drug fever]])
* Hyperpyrexia (suggestive of [[intracranial hemorrhage]], [[septicemia]], [[Kawasaki disease]], [[thyroid storm]], [[drug fever]])
* Hectic or spiking pattern (suggestive of [[biliary tract|biliary]] or [[urinary tract infection]], [[endocarditis]])
* Hectic or spiking pattern (suggestive of [[biliary tract|biliary]] or [[urinary tract infection]], [[endocarditis]])
* Morning temperature spikes (suggestive of [[typhoid fever]], [[tuberculosis]], [[polyarteritis nodosa]])
* Irregular pattern (suggestive of [[fever|factitious fever]])
* Irregular pattern (suggestive of [[fever|factitious fever]])
* Pel-Ebstein pattern (suggestive of [[Hodgkin's lymphoma]])
* Pel-Ebstein pattern (suggestive of [[Hodgkin's lymphoma]])
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* Saddleback pattern (suggestive of [[dengue fever]], [[leptospirosis]], [[poliomyelitis]], [[human granulocytic ehrlichiosis]])
* Saddleback pattern (suggestive of [[dengue fever]], [[leptospirosis]], [[poliomyelitis]], [[human granulocytic ehrlichiosis]])
* Wunderlich curve pattern (suggestive of [[typhoid fever]])
* Wunderlich curve pattern (suggestive of [[typhoid fever]])
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 21:26, 19 March 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: febris continua e causa ignota; febris e causa ignota; febris E.C.I.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO

History

Key components of history include:

  • Pattern or time course of the fever
  • History of previous surgeries or procedures
  • History of malignancy and related therapy
  • History of previously treated infections
  • History of sick or animal contacts
  • History of psychiatric illness
  • History of recent traveling
  • History of comorbidities
  • History of medications
  • History of transfusions
  • Social and family history

Symptoms

Fever patterns

  • Sustained fever: the fluctuation in temperature during a 24-hour period is 0.3 °C (0.5 °F) or less.
  • Remittent fever: the temperature is elevated, and it falls each day, but not to normal, remaining 37.3 °C (99.2 °F) or above. The excursion in temperature is more than 0.3 °C (0.5 °F) and less than 1.4 °C (2.5 °F).
  • Intermittent fever: the temperature is elevated but falls to normal (37.2 °C [99 °F] or below) each day. The excursion in temperature is more than 0.3 °C (0.5 °F) and less than 1.4 °C (2.5 °F).
  • Hectic fever: remittent or intermittent fever, with a difference of 1.4 °C (2.5 °F) or more between peak and trough.[1]

Fever patterns and their clinical significance

The periodicity of fever generally offers little diagnostic value in ascertaining the etiology of fever. Characteristic fever patterns include:[2]

References

  1. Musher, D. M.; Fainstein, V.; Young, E. J.; Pruett, T. L. (1979-11). "Fever patterns. Their lack of clinical significance". Archives of Internal Medicine. 139 (11): 1225–1228. ISSN 0003-9926. PMID 574377. Check date values in: |date= (help)
  2. Isaac, Benedict (1991). Unexplained fever : a guide to the diagnosis and management of febrile states in medicine, surgery, pediatrics, and subspecialties. Boca Raton: CRC Press. ISBN 9780849345562.