pyrexia of unknown origin Flashcards
What is a normal temperature
37 degrees
What temperature is a fever
over 37 degres but not normally significant unless near 38 degrees
When is temperature higherst and lowest in the body
lowest in the morning and highest in the evening
What are pyrogens
Substances which cause fever and act on the thermoregulatory centre of the hypothalamus which causes reduced heat loss and therefore fever
What is the temperature of a pyrexia of unknown origin
greater than 38.3 degrees which is recorded on multiple occasions and is there for more than 3 weeks
The modern definition is 3 outpatient visits or 3 days in hospital with pyrexia
What is nosocomial PUO
develops in hospital - undiagnosed after 3 days
What is neutropenic PUO
Undiagnosed fever in patients with neutrophils lower than 500 mmcubed
What is HIV associated PUO
Patient with HIV with an undiagnosed fever for more than 3 days or 4 weeks as an outpatient
What is important in diagnosing PUO
History and examination
What investigations are done in PUO
chest X-ray
urinalysis
full blood count
CRP and Erythrocyte
Blood cultures
Urea, creatinine, electrolytes, LFTs
What is a fabricated fever
Self induced fever via injection commonly - normally individuals who have worked in self care
What is the treatment of PUO
Normally spontaneously goes away in younger patients
Responds to NSAIDs and steroids
