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Fever Of Unknown Origin

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Anupama Gowda
Anupama Gowda
Saúde e medicina
1 de 30
FEVER OF UNKNOWN ORIGIN Anupama Gowda Medical Student, 3 rd year Medical University of the Americas, Belize campus Internal Medicine Rotation Jackson Park Hospital
THE BASICS OF FEVER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DEFINITION ,[object Object],[object Object],[object Object],[object Object]
Differentiation from Hyperthermia ,[object Object],[object Object]
OUTCOMES from HYPERTHERMIA ,[object Object],[object Object],[object Object]
EFFECTOR MECHANISMS ,[object Object],[object Object],[object Object],[object Object]
MECHANISM ,[object Object],[object Object],[object Object],[object Object]
MEASUREMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Measurement ,[object Object],[object Object],[object Object],[object Object]
Measurement ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FOUR CLASSIFICATIONS ,[object Object],[object Object],[object Object],[object Object]
IS FEVER GOOD OR BAD? Fever is GOOD….. and BAD…
Right Shift : increase in pCO2, temp, 2,3-BPG, altitude, exercise; decrease in pH Left Shift : decrease in pCO2, temp, 2,3-BPG, HbF; increase in pH Hemogloblin-oxygen dissociation curve
Oxygen-Dependent Myeloperoxidase System
SO WHEN IS FEVER “BAD”? ,[object Object],[object Object],[object Object]
FEVER OF UNKNOWN ORIGIN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MAI (Mycobacterium avium/intercellulare), Tuberculosis, Non-Hodgkin’s, drug fever* Perianal infection, aspergillosis, candidemia, drug fever* Septic thrombophlebitis, sinusitis, C-diff, drug fever* Infections, malignancy, inflammatory diseases, drug fever* Causes (few examples) 3 days or 4 weeks as outpatient 3 days 3 days 3 days or 3 outpatient visits Duration of illness while under investigation Confirmed HIV + 1. Neutrophil count less than 500/ul OR 2. Expected to reach that in 1-2 days 1. Hospitalized 2. Acute care 3. No infection when admitted ALL others with fevers greater than/equal to three weeks Patient’s situation HIV-ASSOCIATED NEUTROPENIC NOSOCOMIAL CLASSIC FEATURE
DRUG FEVER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neutropenic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIV-Associated ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NOSOCOMIAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NOSOCOMIAL-INVESTIGATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIC ,[object Object],[object Object],[object Object]
CLASSIC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIC ,[object Object],[object Object],[object Object],[object Object]
CLASSIC ,[object Object],[object Object]
WHAT HAPPENS…? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SUMMARY
THANK YOU

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Fever Of Unknown Origin

  • 1. FEVER OF UNKNOWN ORIGIN Anupama Gowda Medical Student, 3 rd year Medical University of the Americas, Belize campus Internal Medicine Rotation Jackson Park Hospital
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  • 12. IS FEVER GOOD OR BAD? Fever is GOOD….. and BAD…
  • 13. Right Shift : increase in pCO2, temp, 2,3-BPG, altitude, exercise; decrease in pH Left Shift : decrease in pCO2, temp, 2,3-BPG, HbF; increase in pH Hemogloblin-oxygen dissociation curve
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  • 17. MAI (Mycobacterium avium/intercellulare), Tuberculosis, Non-Hodgkin’s, drug fever* Perianal infection, aspergillosis, candidemia, drug fever* Septic thrombophlebitis, sinusitis, C-diff, drug fever* Infections, malignancy, inflammatory diseases, drug fever* Causes (few examples) 3 days or 4 weeks as outpatient 3 days 3 days 3 days or 3 outpatient visits Duration of illness while under investigation Confirmed HIV + 1. Neutrophil count less than 500/ul OR 2. Expected to reach that in 1-2 days 1. Hospitalized 2. Acute care 3. No infection when admitted ALL others with fevers greater than/equal to three weeks Patient’s situation HIV-ASSOCIATED NEUTROPENIC NOSOCOMIAL CLASSIC FEATURE
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