Fever Presentation Fever with Sweating Brucellosis may be
Fever Presentation
Fever with Sweating • Brucellosis may be liters / day. • Malaria. • Tuberculosis. • Rheumatic fever. • Toxemia, puerperal sepsis, septicemia an closed abscesses as also other causes of irregular rigors.
Fever with Sore throat • Influenza, colds and upper respiratory catarrh. • Acute tonsillitis. • Scarlet fever. • Glandular fever. • Faucial diphtheria • Acute monocytic leukaemia • Quinzy
Fever with Rash 1 - Exanthemata (Very Sick People Must Take Ease) 1. Varicella 2. Scarlet fever 3. Chicken Pox 4. Measles 5. Typhus 6. Enterica (Typhoid) (These are mentioned in the order of appearance of the rash from day of fever ).
2 - Relapsing fever 3 - Glandular fever 4 - Blood diseases as purpura 5 - Drug fever 6 - Skin diseases, e. g. pemphigus, impetigo, infected eczema, syphilis, etc. 7 - Fever with non-specific rash as rheumatic fever (erythema marginatum and others) and cerebrospinal meningitis (petechial).
Fever with Relative Bradycardia 1 - Some specific fever mostly viral : • Mumps • Infective hepatitis • Influenza • Yellow fever • Dengue • Primary atypical pneumonia • Typhoid and paratyphoid • Q-fever • Weil's disease etc…. .
2 - CNS lesions: with rapid rise in intracranial tension e. g : • Pontine hemorrhage • Brain abscess • Tumours • Cerebrospinal fever • Tuberculous meningitis • Uraemia …. etc.
Fever with Rigors • Influenza • Acute tonsillitis • Acute nephritis • Lobar pneumonia • Scarlet fever • Small pox • Typhus • Cerebrospinal fever
When rigors occur in diseases not known to cause rigors, it indicates complications e. g. : • Rigors with hydrothorax indicates extension pyothorax. • Rigors with valvular heart diseases indicates, subacute bacterial endocarditis. • Rigors with otitis media indicates extension of infection to mastoid air cells or lateral sinus.
Rigors are repeated in certain fevers e. g. : • Malaria (regular rigors). • Amoebic hepatitis. • Septicemia • Subacute bacterial endocarditis. • Acute miliary tuberculosis • Charcot's intermittent fever • Closed abscesses under tension
Afebrile rigors may occur after : • Blood transfusion • I. V. fluid therapy. • Catheterization usually due to bacterial pyrogens in the catheter, needle or transfusion apparatus.
Fever with Lymphadenopathy I. Infections : (A) Acute: Generalized : • German measles • Measles • Glandular fever • Brucellosis • Scarlet fever
• Sleeping sickness • Plague Localized : • Diphtheria • Anthrax • Non specific (pyogenic lymphadenitis draining a septic focus)
(B) Chronic : Generalized : • Tuberculosis • Sarcoidosis • Chronic brucellosis • Syphilis
• Localized : • Actinomycosis • Leprosy • Non-specific II. Blood Diseases : • Acute Leukemia • Chronic Lymphatic Leukemia • Hodgkin's disease.
III. Lipoid storage disease: Mostly childhood as: • Infantile Gaucher disease • Nimannpick's disase. IV. Neoplasm: • Lymphoma • Carcinomatous secondaries V. cholagen disease: Still's disease • Felty's syndrome
Fever with Jaundice I. Hepatocellular jaundice: • Infective hepatitis • liver cirrhosis • Hepatocellular failure • Weil's disease • Lobar pneumonia • Septicemias • Glandular fever
• Typhus • Relapsing fever • Yellow fever • Amoebic hepatitis
II. Obstructive jaundice: • Cholangitis • Charcot's intermittent fever • Biliary cirrhosis • Secondaries in liver and Carcinoma of head of pancreas or ampulla of Vater.
III. Hemolytic jaundice: Any hemolytic attack is usually accompanied by fever, especially in : • Malaria • Black water fever • Gas gangrene • Congenital hemolytic anemia.
Fever with Splenomegaly I. Infections : Bacterial : • Typhoid • Paratyphoid • Brucellosis • Septicaemia • Subacute bacterial endocarditis • Weil's disease
• Tuberculosis • Syphilis • Rickettsial : Relapsing fever • Scarlatina Viral: • Measles • Infective hepatitis • Glandular fever
Parasitic: • Malaria • Kala-azar • Early stage of hepatic bilharziasis • Sleeping sickness • Hydatid disease
II. Blood diseases: All diseases leading to increase or decrease of blood elements. Leucocyte : • Leucocytosis Leukemias (acute or chronic). • Leucopenia. Cyclic neutropenia Hypoplasia ( of bone marrow)
Red cells : All anemias specially : • Hemolytic • Pernicious , Iron deficiency • Hypoplastic. • Polycythemia Platelets : • Thrombocytopenia • Thrombocytosis
Reticulosis : as Hodgkin's disease III. Metabolic disturbances • Thyrotoxicosis • Secondary amyloidosis • Hemochromatosis • Rickets • Gaucher's disease
IV. Splenic focal lesions : • Abscess • Cysts as hydatid cyst • Tumours as Sarcoma or secondaries V. Vascular: • Portal hypertension • Congestive heart failure
VI. Collagen diseases: • Dissminated lupus erythematosus(SLE) • Still's disease • Felty's syndrome VII. Others : • Sarcoidosis • Ulcerative colitis
Fever with Hepatomegaly Liver tender: • Infective hepatitis • Amoebic and pyemic hepatitis • Malignancy No or minimal tenderness: I. Infections (mainly bacterial) as: • Tuberculosis • Leprosy
• Actinomycosis • Weil's diseases • Relapsing fever • Brucellosis • Syphilis • Glandular fever • Yellow fever • Sarcoidosis
• Parasitic infections as: *Early bilharziasis *Malaria *Kala azar *Hydatid diseases III. Cirrhosis IV. Malignant liver V. Metabolic diseases and amyloidosis VI. Blood diseases and reticulosis as: leukemias, hemolytic and pernicious anemias.
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