Fever

  • Perform a focused history and physical exam to determine presence of fever, fever pattern, and associated symptoms and signs, so as to:
    • Make a determination as to whether a patient truly has/ had a fever, and whether it is acute versus chronic.
    • Identify patients with serious illness
      • Demonstrate good understanding of the potential causes of fever, including infection, malignancy, drugs, environment (sun, heat).
      • Recognize the red flags of fever.
  • Recognize special groups where fever has different significance or impact (neonates, elderly patients, travel/immigrant issues, under-immunized groups, living conditions, immunocompromised individuals).
  • Propose a plan for appropriate investigation of possible causes, based on the local context, especially in the pediatric patient.
  • Propose a basic plan of management that includes:
    • At home measures including antipyretics.
    • Guidance for patients/caregivers on how to access care depending on evolution of illness.

Articles

Fever Clinical Card

Chung AB, Bannister SL, Keegan DA. Fever. Canadian Family Medicine Clinical Card. 2011. Available at: https://sites.google.com/site/sharcfm/

Top 10 differential diagnoses in family medicine - Fever

Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Fever. Can Fam Physician. 2007;53(7):1202. doi: 53/7/1202 [pii].

Approach to the Adult Patient with FUO

Roth AR, Basello GM. Approach to the adult patient with fever of unknown origin. Am Fam Physician. 2003;68(11):2223-2228.