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* '''Mononucleosis-like illness''' is the triad of fever, pharyngitis, and lymphadenopathy which suggests [[infectious mononucleosis]]. Other possible causes include cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), [[human immunodeficiency virus]] (HIV), [[human adenovirus]], herpes simplex virus (HSV), Streptococcus pyogenes, and Toxoplasma gondii.<ref name="pmid17904463">{{cite journal |author=Hurt C, Tammaro D |title=Diagnostic evaluation of mononucleosis-like illnesses |journal=Am. J. Med. |volume=120 |issue=10 |pages=911.e1–8 |year=2007 |pmid=17904463 |doi=10.1016/j.amjmed.2006.12.011}}</ref> | * '''Mononucleosis-like illness''' is the triad of fever, pharyngitis, and lymphadenopathy which suggests [[infectious mononucleosis]]. Other possible causes include cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), [[human immunodeficiency virus]] (HIV), [[human adenovirus]], herpes simplex virus (HSV), Streptococcus pyogenes, and Toxoplasma gondii.<ref name="pmid17904463">{{cite journal |author=Hurt C, Tammaro D |title=Diagnostic evaluation of mononucleosis-like illnesses |journal=Am. J. Med. |volume=120 |issue=10 |pages=911.e1–8 |year=2007 |pmid=17904463 |doi=10.1016/j.amjmed.2006.12.011}}</ref> | ||
* '''Relative bradycardia''' is when the "pulse is less than expected at a given body temperature"<ref name="pmid18003964">{{cite journal |author=Babyatsky MW, Keroack MD, Blake MA, Rosenberg ES, Mino-Kenudson M |title=Case 35-2007 -- A 30-Year-Old Man with Inflammatory Bowel Disease and Recent Onset of Fever and Bloody Diarrhea |journal= |volume=357 |issue=20 |pages=2068–2076 |year=2007 |pmid=18003964 |doi=10.1056/NEJMcpc079029}}</ref> Relative bradycardia suggests an intracellular organism such as [[salmonella]], [[legionella]], and [[chlamydia]].<ref name="pmid18003964"/> Other causes include [[Sandfly fever]], [[Dengue fever]], and maybe some cases of drug induced fever<ref name="pmid3565971">{{cite journal |author=Mackowiak PA, LeMaistre CF |title=Drug fever: a critical appraisal of conventional concepts. An analysis of 51 episodes in two Dallas hospitals and 97 episodes reported in the English literature |journal=Ann. Intern. Med. |volume=106 |issue=5 |pages=728-33 |year=1987 |pmid=3565971 |doi=}}</ref>. | * '''Relative bradycardia''', Faget's sign, is when the "pulse is less than expected at a given body temperature"<ref name="pmid18003964">{{cite journal |author=Babyatsky MW, Keroack MD, Blake MA, Rosenberg ES, Mino-Kenudson M |title=Case 35-2007 -- A 30-Year-Old Man with Inflammatory Bowel Disease and Recent Onset of Fever and Bloody Diarrhea |journal= |volume=357 |issue=20 |pages=2068–2076 |year=2007 |pmid=18003964 |doi=10.1056/NEJMcpc079029}}</ref> Relative bradycardia suggests an intracellular organism such as [[salmonella]], [[legionella]], and [[chlamydia]].<ref name="pmid18003964"/> Other causes include [[Sandfly fever]], [[Dengue fever]], and maybe some cases of drug induced fever<ref name="pmid3565971">{{cite journal |author=Mackowiak PA, LeMaistre CF |title=Drug fever: a critical appraisal of conventional concepts. An analysis of 51 episodes in two Dallas hospitals and 97 episodes reported in the English literature |journal=Ann. Intern. Med. |volume=106 |issue=5 |pages=728-33 |year=1987 |pmid=3565971 |doi=}}</ref>. | ||
* '''Arthropathy''', when prominent, suggests [[Parvovirus B19]]. | * '''Arthropathy''', when prominent, suggests [[Parvovirus B19]]. | ||
* '''Myalgias''', when prominent, suggests [[Dengue fever]]. | * '''Myalgias''', when prominent, suggests [[Dengue fever]]. When myalgias localize to the calves, low back, or abdomen, consider [[leptospirosis]]. | ||
* '''Headache''', when prominent, suggests [[West Nile Virus]]. | * '''Headache''', when prominent, suggests [[West Nile Virus]]. | ||
* '''Conjunctival injection''', when prominent, suggests [[Dengue fever]], [[Chikungunya]] fever, or [[leptospirosis]]. | |||
* Liver and renal failure when present, suggest [[leptospirosis]] ("Weil's disease") | |||
* Vertebral osteomyelitis or spondylitis suggests [[brucellosis]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Physical examination]] | [[Category:Physical examination]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Signs and Symptoms
The elevation in thermoregulatory set-point means that the previous "normal body temperature" is considered hypothermic, and effector mechanisms kick in. The person who is developing the fever has a cold sensation, and an increase in heart rate, muscle tone and shivering in an attempt to counteract the perceived hypothermia, thereby reaching the new thermoregulatory set-point.
- Influenza-like illness is defined as "fever (temperature of 100°F [37.8°C] or greater) and a cough and/or a sore throat in the absence of a known cause other than influenza."[1] Possible causes include respiratory syncytial virus, rhinovirus, adenovirus, parainfluenza viruses, coronaviruses, and metapneumovirus.[2]
- Mononucleosis-like illness is the triad of fever, pharyngitis, and lymphadenopathy which suggests infectious mononucleosis. Other possible causes include cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), human immunodeficiency virus (HIV), human adenovirus, herpes simplex virus (HSV), Streptococcus pyogenes, and Toxoplasma gondii.[3]
- Relative bradycardia, Faget's sign, is when the "pulse is less than expected at a given body temperature"[4] Relative bradycardia suggests an intracellular organism such as salmonella, legionella, and chlamydia.[4] Other causes include Sandfly fever, Dengue fever, and maybe some cases of drug induced fever[5].
- Arthropathy, when prominent, suggests Parvovirus B19.
- Myalgias, when prominent, suggests Dengue fever. When myalgias localize to the calves, low back, or abdomen, consider leptospirosis.
- Headache, when prominent, suggests West Nile Virus.
- Conjunctival injection, when prominent, suggests Dengue fever, Chikungunya fever, or leptospirosis.
- Liver and renal failure when present, suggest leptospirosis ("Weil's disease")
- Vertebral osteomyelitis or spondylitis suggests brucellosis
References
- ↑ Centers for Disease Control and Prevention (2007). "CDC - Influenza (Flu) - Flu Activity". Retrieved 2007-11-19.
- ↑ Kelly H, Birch C (2004). "The causes and diagnosis of influenza-like illness". Australian family physician. 33 (5): 305–9. PMID 15227858.
- ↑ Hurt C, Tammaro D (2007). "Diagnostic evaluation of mononucleosis-like illnesses". Am. J. Med. 120 (10): 911.e1–8. doi:10.1016/j.amjmed.2006.12.011. PMID 17904463.
- ↑ 4.0 4.1 Babyatsky MW, Keroack MD, Blake MA, Rosenberg ES, Mino-Kenudson M (2007). "Case 35-2007 -- A 30-Year-Old Man with Inflammatory Bowel Disease and Recent Onset of Fever and Bloody Diarrhea". 357 (20): 2068–2076. doi:10.1056/NEJMcpc079029. PMID 18003964.
- ↑ Mackowiak PA, LeMaistre CF (1987). "Drug fever: a critical appraisal of conventional concepts. An analysis of 51 episodes in two Dallas hospitals and 97 episodes reported in the English literature". Ann. Intern. Med. 106 (5): 728–33. PMID 3565971.