Endocarditis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Endocarditis often presents as an unexplained fever and must be distinguished from other causes of a fever of unknown origin (FUO).
Differential Diagnosis
Causes of a fever of unknown origin which endocarditis must be differentiated from include a drug fever, cotton fever, lymphoma, pulmonary embolism, and deep vein thrombosis. Disseminated granulomatoses such as Tuberculosis, Histoplasmosis, Coccidioidomycosis, Blastomycosis and Sarcoidosis can also cause a FUO. Blood cultures and echocardiography are critical in differentiating endocarditis from these other syndromes.
Drug Fever
A drug fever will resolve with discontinuation of the offending agent. There may be elevated urine eosinophils and a peripheral eosinophilia as well.
Cotton Fever
The symptoms of cotton fever resemble those of sepsis and patients may be initially misdiagnosed upon admission to a hospital. However sepsis is a serious medical condition which can lead to death, whereas cotton fever, if left alone, will usually resolve itself spontaneously within 12-24 hours. Symptoms usually appear with 10-20 minutes after injection and in addition to fever may include headaches, malaise, chills, nausea and tachycardia. The fever itself usually reaches 38.5 - 40.3°C (101 - 105°F) within the first hour.[1]
References
- ↑ Harrison DW, Walls RM (1990). ""Cotton fever": a benign febrile syndrome in intravenous drug abusers". J Emerg Med. 8 (2): 135–9. PMID 2362114.