history

A detailed fever history including :

onset
frequency
duration of fever
response or nonresponse to
therapy
recurrence
and associated symptoms
 HISTORY
History should be taken from the child or
reliable informant
AGE helpful in evaluating FUO.
Children >6 yr of age often have a
respiratory or genitourinary tract infection,
localized infection (abscess, osteomyelitis),
JIA(Juvenile Idiopathic Arthritis), leukemia
Adolescent patients are more likely to
have inflammatory bowel disease,
autoimmune processes, lymphoma, or
tuberculosis
 ADDRESS -> endemic regions for malaria

History of fever and other symptoms should

be taken in chronological order,give clue
towards system involved
eg:-
fever,dysuria ,loin pain UTI
fever ,drowsiness ,convulsions -
meningitis, encephalitis
 HOPI
ONSET
GRADE
DURATION

fever
 PROGRESSION -> Viral fever peaks in 2 days and declines
-> Bacterial fever worsens day by day without treatment
-> Parasite fever like malaria shows cyclical cold,hot and
sweating stages.

TYPE -> Continuous-Pneumonia ,UTI

-> Remittent-Viral, collagen vascular diseases
-> Intermittent - Malaria , Brucellosis
-> Step ladder fever-Typhoid.

Associated with ->

Chills and rigors- Malaria,brucellosis ,otitis media
Myalgia- brucellosis,dengue

Sweating-Meningitis , TB ,Bacteraemia ,Malaria

 History of travel malaria
Pets toxoplasmosis
Contact with animals
leptospirosis,brucellosis
Blood transfusion - malaria,hepatitis-B
Migrating joint pains - Rheumatic fever
Loss of weight -malignancies
History of recurrent fever ,oral thrush -
immunocompromised
Joint pains,rash,photosensitivity -
autoimmune
 Family history - similar complaints suggest
infectious disease,

Feeding history - diet -> unpasteurized

milk(brucellosis,TB),raw egg (salmonella)

Loss of appetite - malignancies ,TB

Immunization history - vaccination induced fever.

e.g,DPT,measles

Treatment history - drug induced fever