Paediatric- History taking & Physical examination of a patient with fever of unknown origin

Paediatric- History taking & Physical examination of a patient with fever of unknown originCreated OnApril 22, 2020Last Updated OnApril 22, 2020byadmin You are here: Main Clinical Examination Paediatric- History taking & Physical examination of a patient with fever of unknown origin < All Topics Table of Contents History taking: Ask about patient’s data: name, age, gender Ask about history of presenting illness History of fever? Onset Duration Pattern Responsive/ not responsive to antipyretics Associated with chills and rigors? History of chronic, productive cough, loss of weight, haemoptysis, shortness of breath (SOB) – TB History of dyspnea on exertion, chest pain, palpitation – IE History of crying during micturition, dysuria, haematuria – UTI History of cough, nasal congestion, sorethroat – URTI History of joint pain/ swelling, limping gait, rashes – systemic JIA History of malar flush, photosensitivity, oral ulcer, joint pain/ swelling – SLE History of red watery eyes, injected pharynx, red lips, strawberry tongue, swelling of palms and soles, rashes, lymphadenopathy – Kawasaki disease Constitutional symptoms: loss of weight, loss of appetite – Malignancy History of SOB on exertion, palpitation, easy fatigability, easily fall sick, bleeding/ bruising tendencies – Leukemia Swollen lymph nodes, weight loss, fatigue – Lymphoma History of excessive sweating, heat intolerance, irritable, tremors, diarrhoea – Hyperthyroidism Exposure to wild/ domestic animals? – cat scratch fever History of tick bite History of sick contact – Tuberculosis (TB) Ask about systemic review CVS: rapid breathing on exertion, SOB, palpitation Respiratory: rapid breathing, productive/ dry cough, wheezing, haemoptysis GI: reduced oral intake, vomiting, diarrhoea, abdominal pain/ distension, constipation, jaundice Renal: reduced urine output, haematuria, crying during micturition, changes in frequency, amount or colour of urine CNS: irritability, headache, fit, weakness, pain, incontinence, loss of consciousness MSK: joint pain, joint stiffness, joint deformities, joint swelling, difficulty ambulating Skin: rashes, dryness, pigmentation, itching, discolouration Eye: red eyes, watery eyes, blurring of vision, diplopia Ear, Nose, Throat: ear discharge, hearing loss, nasal block, hoarseness of voice Ask about travel history Recent traveling in the past 1 year? – to malaria/ TB endemic countries? Visit to the waterfall? – leptospirosis Ask about antenatal history History of congenital infection History of intrauterine growth restriction (IUGR)? Ask about birth history Gestational age at delivery? Birth weight? Mode of delivery? Hx of postnatal complications? Ask about vaccination history Completely/ incompletely/ unimmunized? Ask about feeding history Type of food/ milk Frequency and amount being fed Any reduced oral...

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