Sepsis, septic shock, PUO Flashcards
PUO definition
Temperature > 38.3
At least 3 weeks
No identified cause
3 days inpatient/ 3 outpatient visits
Questions to ask about for PUO
Onset/ duration
Course
Pattern
Severity
Relieving/ exacerbating factors
Associated features
Associated features in PUO
Fatigue
Weight loss
Itching/ rash
Rigors
Pain
Swelling/ lumps
Infectious causes of PUO
Tuberculosis
Sinusitis
Endocarditis
Abscess (intrabdominal/ pelvic)
CMV, EBV
Inflammatory causes of PUO
Polymyalgia rheumatica
Vasculitis
Sarcoidosis
SLE
Temporal arteritis
Adult’s Still’
Neoplastic causes of PUO
Leukaemia
Lymphoma
Renal cell carcinoma
Metastatic
PMH for PUO
Previous infections
Surgery/ indwelling devices
Immunosuppresion conditions
Cancer/ autoimmune conditions
Drug Hx for PUO
Antibiotics
Immunosuppressant
Antipyretic
Change in meds
Social Hx for PUO
Recent travel
Country of birth/ residence
Occupation/ exposures
Unwell contacts
Exposure to animals
Smoking/ alcohol/ recreational drug
Hobbies
First line investigations for PUO
FBC, U+Es, LFTS
Bone profile, renal function
Viral hepatitis serology if abnormal LFTs
CRP, ESR
HIV
3 sets blood cultures
Dipstick, urine MC+S
CXR
First line agents for TB
RIPE:
- Rifampicin
- Isoniazid
- Pyrazinamide
- Ethambutnol
_______ is used to indentify the presennce of antimicrobial resistance in TB
Whole genome sequencing
Acute Fever Hx summary (FEVER)
Fever details
- Course, onset, pattern, associated symptoms,
Exposure
Vulnerability
Systemic equiry
Drugs (Rx)
