for beginner 2024 new update Fever presentation

2024 new update

1. Fever presentation BY : Dr , WALAA SALAH MANAA Consultant of pediatric infectious disease مـستشفى حمـيات كـفر الشـيخ

2. Fever with headache Menengitis,encephalitis , menengism ……… (occipital). Influenza, common cold. Typhoid…( frontal+dullach ) RVF. malaria .

3. Fever with chills or rigor Chill : sensation of coldness. Rigor : tonic contraction of muscles + shacking of whole body. + stucking of the teeth . Chill : may accompany marked rise of temp. in any fever.

4. Rigors 1-malaria 2-influenza 3-UTI. 4-pyaemia & septicaemia . 5- pus under tension ( subphrenic abscess,,,,liver abscess,,,, cholangitis,,,,Puerperal sepsis). 6-after IV fluid containing pyrogens . 7-after taking antipyretics.dt sudden drop of temp.

5. Fever with pains 1-Eye pain  mostly viral in origin. 2-Backpain  meningitis ,encephalitis , dengue , brucellosis 3-Chest pain  bronchitis , pneumonia, pleurisy. 4-abdominal pain  typhoid , peritonitis, hepatitis.

6. Fever with epistaxis 1-Acute typhoid fever. 2-Acute Rh. Fever. 3-Acute leukemia. 4-haemorrahgic fevers. 5 others.

7. Fever with pallor: 1-Acute Rh. Fever. 2-malaria. 3-Haemolytic anaemia . 4-Malignancies.

8. Fever with herpes labialis : 1-Common cold & influenza. 2-Malaria. 3-Meningo coccal meningitis. 4-Pneumococcal pneumonia. exclude typhoid and brucella

9. Fever with jaundice 1-Viral hepatitis. 2-Paratyphoid B fever. 3-I.M.N. 4-Liver abscess. 5-Falciparum malaria. 6-Haemolytic crises. 7-Septic cholangitis. 8-Acute leukemia. 9-Yellow fever.

10. Fever with convulsion: 1-febrile convulsion. 2-C.N.S.infection. 3-fever associated with other causes of seizures : * epilepsy . * cerebral stroke . * cerebral tumor. *cerebral trauma . * drug or alcohol withdrawal .

11. Fever with coma 1-CNS infection encephalitis meningoencephalitis (viral, bact., rechetsial , fungal, parasitic.) 2-cerebro-vascular stroke ( pontine hge . , subarachnoid hge ., cerebral hge .) 3-infection associated with CNS trauma , brain tumor , toxic coma : * external toxins (poison ingestion) * internal toxins . eg . diabetic coma, uremia , hepatic coma ,,,,,,,)

12. Do not diagnose hysterical coma in febrile pt. Do not lose the hope or the prognosis in prolonged coma. Fever with coma

13. Fever with rash May indicate a serious bacterial infection in 20% of cases ( e.g.menengococcal menengitis , HIb ,,,,,,,,,) 80% of cases are caused by viral infection.

14. Fever with rash 1-very  ( varecilla ) chicken pox & menigitis . 2-Sick  scarlet fever & erysipelas. 3-People small pox. 4-Must  measles. 5-Take  typhus. 6-Entire  enterica . 7-good  glandular fever. 8-Rest  relapsing fever.

15. 1-Very

16. 2-Sick

17. 3-People 4-Must

18. 5-Take 6-Entire

19. 7-good 8-Rest

20. Dangerous sings in fever with rash 1-if associated with sever constitutional S&S. 2-if hemorrhagic. 3-if is extensive. 4-if associated with shock or coma.

21. fever Hosp. cases (1)

22. 15 yr. old female pt. presented by fever,arthralgia . ESR..40-75… ASOT 400 With history of recurrent tonsillitis My diagnosis was Rh. Fever& I start LAP. ………………………… …………………………(true….false).

23. 10yr old male presented by fever ,vomiting , abd.pain since 2 days Widal test was done 1/160 my diagnosis was typhoid fever & start ttt by ciprofloxacin………………………………… …………………………(true….false).. (2)

24. Widal test (O) raising.7-10 day. (H)------carrier..

25. Case definition Suspected case : fever,headache,abd . Discomfort, +at least 3 of the following: 1-toxic look 2-bronchitic chest. 3- typantic abdomen 4-palpable recessive spleen (disappear after cure)

26. Probable case : suspected case+ + ve Widal test by tube agglutination>160 after 1 week of fever. Confirmed case: any suspected case with + ve blood culture. Or : significant rise in the tube agglutination. N.B . bright spleen is one of the abdominal U/S findings if the bright spleen is reversible after cure.

27. (3)

28. Degree of tetanus: Mild: trismus ,distance between upper & lower incisors >2cm. Moderate: trismus + mild fits+ D.I <2cm. Severe : trismus +frequent fits +(D.I)<1cm

29. (4)

30. Thank You