Speciality
Spotlight

 




 


Family Practice


 

 







Infectious
Disease – Fever

             

An
oral temperature greater than 98.9 F [at 6.00 am] or
99.9 F [at 6:00 pm] would define a fever.

  

History

Attention should be paid to the chronology of symptoms
or any surgical or dental procedure. Occupational
history includes exposure to animals, toxic fumes, or
other febrile individuals. History of IV drugs, trauma,
animal or insect bites, prior trnsfusions, immunisations
or drug allergy is necessary.

 

Patterns

A fever could be presistent, intermittent, remittent or
relapsing. However, the widespread use of antipyretics
antibiotics, or steroids can alter the course of fever.

 

Axillary temperature is unreliable. Oral temperature is
reliable, but it can mislead if taken immediately, after
consumption of hot or cold drink, smoking or
hyperventilation.

 

Laboratory Test

If the history and physical examination suggest more
than a simple viral illness or a streptococcal
pharyngitis than only laboratoy tests are indicated.

 

Treatment

In practice fever is often suppressed by the use of
antipyretics which can obscure important clinical
information. A low grade or moderate fever is not
harmful and a routine use of antipyretics should be
avoided.

 

Fever

 

With Chills

Malaria, UTI,
Septicemia

 

Loss of appetite, vomiting, photophobia

Viral hepatitis

 

Headache, vomiting, stiff neck

Meningitis

 

Loss of weight, appetite, Sweating at night, hemoptysis,
cough

T.B.

 

High fever, headache with rose spots, bradycardia

Typhoid

 

Throat pain, difficulty in swallowing

Tonsilitis, Pharyngitis

 

With Rashes

Chicken Pox, measles drug allergy

 

With clubbing of finger, Palpable spleen and petechiae

Endocarditis






Malaria Influenza Typhoid Pneumonia

Peripheral
blood smear


WBC
count – Low to normal 


Treatment


1.     
Chloroquine


2.     
Sulfadoxine +        


          
Pyrimethamine


3.       
Primaquine

 


UTI


Tenderness
in costoverterbal angle.


Frequency
of urine


Burning
of urine


Urine
routine test


Urine
culture and sensitivity


 


Treatment


TMP
+Sulfamethaxazole


Ciprofloxacin


 


Viral
Hepatitis


Photophobia


Altered
taste and smell


Jaundice


Tenderness
of liver


Liver
funciton test.



Photophobia


Burning
eyes


Cough,
sore throat


Throat
swab for isolation of virus low WBC count.


 


Meningitis


Confusion,
delirium


Lethargy
or coma stiff neck. Examination of CSF


Blood
culture and sensitivity


 


Treatment


Ampicillin


Cefotaxime


Aminoglycosides


 


Tuberculosis


Chest
X-Ray


Sputum
for AFB


Sputum
culture


Lymph
node biopsy


 


Treatment


Isoniarid


Rifampin


Ethambutol


Streptomycin

Prolonged
and persistent fever.


Mild
hepato-splenomegaly Bradycardia relative to
fever. Rose’ Spots on chest and abdomen.
Severe anorexia. 
Change in sensorium. 
Low WBC count.  Blood culture Widal test.


 


Treatment


Chloramphenicol


Ciprofloxacin


 


Endocarditis


Splenomegaly


Murmur


Petechaie


Clubbing


Anemia


Proteinuria


Microscopic
Hematuria.


Positive
blood culture


 


Treatment


Penicillin


Cephalosporin


Vancomycin

X-ray
Chest SputumCough


And
sensitivity Gram’s staining of sputum


 


Treatment


Penicillin


Cephalosporin


Erythormycin


 


Liver
Abscess


Liver
tenderness


USG
of liver


 


Treatment


Metronidazole






 

 

Speciality Spotlight

 

 

Infectious Disease – Fever
             

An oral temperature greater than 98.9 F [at 6.00 am] or 99.9 F [at 6:00 pm] would define a fever.
  
History
Attention should be paid to the chronology of symptoms or any surgical or dental procedure. Occupational history includes exposure to animals, toxic fumes, or other febrile individuals. History of IV drugs, trauma, animal or insect bites, prior trnsfusions, immunisations or drug allergy is necessary.
 
Patterns
A fever could be presistent, intermittent, remittent or relapsing. However, the widespread use of antipyretics antibiotics, or steroids can alter the course of fever.
 
Axillary temperature is unreliable. Oral temperature is reliable, but it can mislead if taken immediately, after consumption of hot or cold drink, smoking or hyperventilation.
 
Laboratory Test
If the history and physical examination suggest more than a simple viral illness or a streptococcal pharyngitis than only laboratoy tests are indicated.
 
Treatment
In practice fever is often suppressed by the use of antipyretics which can obscure important clinical information. A low grade or moderate fever is not harmful and a routine use of antipyretics should be avoided.
 
Fever
 
With Chills
Malaria, UTI, Septicemia
 
Loss of appetite, vomiting, photophobia
Viral hepatitis
 
Headache, vomiting, stiff neck
Meningitis
 
Loss of weight, appetite, Sweating at night, hemoptysis, cough
T.B.
 
High fever, headache with rose spots, bradycardia
Typhoid
 
Throat pain, difficulty in swallowing
Tonsilitis, Pharyngitis
 
With Rashes
Chicken Pox, measles drug allergy
 
With clubbing of finger, Palpable spleen and petechiae
Endocarditis

Malaria

Influenza

Typhoid

Pneumonia

Peripheral blood smear

WBC count – Low to normal 

Treatment

1.      Chloroquine

2.      Sulfadoxine +        

           Pyrimethamine

3.        Primaquine

 

UTI

Tenderness in costoverterbal angle.

Frequency of urine

Burning of urine

Urine routine test

Urine culture and sensitivity

 

Treatment

TMP +Sulfamethaxazole

Ciprofloxacin

 

Viral Hepatitis

Photophobia

Altered taste and smell

Jaundice

Tenderness of liver

Liver funciton test.


Photophobia

Burning eyes

Cough, sore throat

Throat swab for isolation of virus low WBC count.

 

Meningitis

Confusion, delirium

Lethargy or coma stiff neck. Examination of CSF

Blood culture and sensitivity

 

Treatment

Ampicillin

Cefotaxime

Aminoglycosides

 

Tuberculosis

Chest X-Ray

Sputum for AFB

Sputum culture

Lymph node biopsy

 

Treatment

Isoniarid

Rifampin

Ethambutol

Streptomycin

Prolonged and persistent fever.

Mild hepato-splenomegaly Bradycardia relative to fever. Rose’ Spots on chest and abdomen. Severe anorexia.  Change in sensorium.  Low WBC count.  Blood culture Widal test.

 

Treatment

Chloramphenicol

Ciprofloxacin

 

Endocarditis

Splenomegaly

Murmur

Petechaie

Clubbing

Anemia

Proteinuria

Microscopic Hematuria.

Positive blood culture

 

Treatment

Penicillin

Cephalosporin

Vancomycin

X-ray Chest SputumCough

And sensitivity Gram’s staining of sputum

 

Treatment

Penicillin

Cephalosporin

Erythormycin

 

Liver Abscess

Liver tenderness

USG of liver

 

Treatment

Metronidazole


 

By |2022-07-20T16:43:22+00:00July 20, 2022|Uncategorized|Comments Off on Infectious Disease

About the Author: