Fever of unknown origin physical examination: Difference between revisions
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{{SK}} febris continua e causa ignota; febris e causa ignota; febris E.C.I.; FUO; PUO | {{SK}} febris continua e causa ignota; febris e causa ignota; febris E.C.I.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO | ||
==Physical Examination== | |||
===Appearance of the Patient=== | |||
===Vitals=== | |||
====Temperature==== | |||
* A [[fever]] is often present. The [[Fever of unknown origin history and symptoms#Fever patterns|periodicity of fever]] may have clinical significance in selected contexts. | |||
====Pulse==== | |||
=====Rate===== | |||
* Physiologically, fever is accompanied by [[tachycardia]] | |||
* [[Faget's sign|Relative bradycardia (Faget's sign)]] may be present | |||
===Skin=== | |||
===Head=== | |||
* Abnormalities of the head/hair may include ___ | |||
===Eyes=== | |||
* Ophthalmoscopic exam may be abnormal with findings of ___ | |||
===Ears=== | |||
===Nose=== | |||
===Throat=== | |||
===Neck=== | |||
* [[Jugular venous pressure]] may be elevated | |||
* [[Carotid bruits]] may be present | |||
* [[Lymph nodes]] may be present | |||
* [[Thyromegaly]] may be present | |||
* [[Hepatojugular reflux]] may be present | |||
===Lungs=== | |||
* [[Pulmonary edema]] and [[rales]] may be present | |||
* [[Wheezing]] may be present | |||
* Consolidation may be present with reduced breath sounds auscultated | |||
* [[Rales]] may be present | |||
* [[Egophony]] may be present | |||
* Chest movement may be asymmetric | |||
===Heart=== | |||
* A [[heave]] may be present | |||
* A [[thrill]] may be present | |||
* A [[friction rub]] may be present | |||
====Auscultation==== | |||
* [[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]] | |||
* [[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]] | |||
* [[Heart sounds#Third heart sound S3|S3]] | |||
* [[Heart sounds#Fourth heart sound S4|S4]] | |||
* [[Heart sounds#Summation Gallop|Gallops]] | |||
* A [[systolic murmur]] best heard at the base may be present | |||
* A [[systolic murmur]] best heard at the apex may be present | |||
* A [[diastolic murmur]] may be present | |||
===Abdomen=== | |||
* [[Abdominal distention]] may be present | |||
* [[Abdominal tenderness]] may be present | |||
* [[Rebound tenderness]] may be present | |||
* An [[acute abdomen]] may be present | |||
* An abdominal mass may be present | |||
* Guarding may be present | |||
* [[Hepatomegaly]] may be present | |||
* [[Splenomegaly]] may be present | |||
* Genitourinary exam if relevant | |||
===Extremities=== | |||
* [[Clubbing]] may be present | |||
* [[Cyanosis]] may be present | |||
* [[Edema]] may be present | |||
===Neurologic=== | |||
* Mental status may be altered | |||
* Conjunctivae: Roth's spots or conjunctival hemorrhage in infective endocarditis | |||
* Oropharynx: oral thrush in HIV/AIDS | |||
* temporal artery (eg, temporal arteritis) | |||
* [[Relative bradycardia]] (s/o [[legionellosis]], [[brucellosis]], [[psittacosis]], [[leptospirosis]], [[drug fever]], [[fever|factitious fever]]) | |||
==References== | ==References== | ||
Revision as of 20:00, 20 March 2015
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Resident Survival Guide |
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Fever of unknown origin Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Fever of unknown origin physical examination On the Web |
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American Roentgen Ray Society Images of Fever of unknown origin physical examination |
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Risk calculators and risk factors for Fever of unknown origin physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: febris continua e causa ignota; febris e causa ignota; febris E.C.I.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO
Physical Examination
Appearance of the Patient
Vitals
Temperature
- A fever is often present. The periodicity of fever may have clinical significance in selected contexts.
Pulse
Rate
- Physiologically, fever is accompanied by tachycardia
- Relative bradycardia (Faget's sign) may be present
Skin
Head
- Abnormalities of the head/hair may include ___
Eyes
- Ophthalmoscopic exam may be abnormal with findings of ___
Ears
Nose
Throat
Neck
- Jugular venous pressure may be elevated
- Carotid bruits may be present
- Lymph nodes may be present
- Thyromegaly may be present
- Hepatojugular reflux may be present
Lungs
- Pulmonary edema and rales may be present
- Wheezing may be present
- Consolidation may be present with reduced breath sounds auscultated
- Rales may be present
- Egophony may be present
- Chest movement may be asymmetric
Heart
- A heave may be present
- A thrill may be present
- A friction rub may be present
Auscultation
- S1
- S2
- S3
- S4
- Gallops
- A systolic murmur best heard at the base may be present
- A systolic murmur best heard at the apex may be present
- A diastolic murmur may be present
Abdomen
- Abdominal distention may be present
- Abdominal tenderness may be present
- Rebound tenderness may be present
- An acute abdomen may be present
- An abdominal mass may be present
- Guarding may be present
- Hepatomegaly may be present
- Splenomegaly may be present
- Genitourinary exam if relevant
Extremities
Neurologic
- Mental status may be altered
- Conjunctivae: Roth's spots or conjunctival hemorrhage in infective endocarditis
- Oropharynx: oral thrush in HIV/AIDS
- temporal artery (eg, temporal arteritis)
- Relative bradycardia (s/o legionellosis, brucellosis, psittacosis, leptospirosis, drug fever, factitious fever)