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Fever management detailed, Slides of Clinical Medicine

West Bengal University of Health SciencesClinical Medicine

It is very important documents based on Harrison internal medicine latest edition

Typology: Slides

2022/2023

Available from 07/25/2024

mrinmoy-naskar
mrinmoy-naskar 🇮🇳

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Midnapore medical College and hospital
West bengal university of health sciences
MANAGEMENT OF FEVER
Common Laboratory Tests for Fever
1. Complete Blood Count (CBC)
–White Blood Cell (WBC) Count: Elevated WBC count
(leukocytosis) can indicate an infection.
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Midnapore medical College and hospital

West bengal university of health sciences

MANAGEMENT OF FEVER

Common Laboratory Tests for Fever

1. Complete Blood Count (CBC)

  • White Blood Cell (WBC) Count : Elevated WBC count (leukocytosis) can indicate an infection.
  • Differential Count : Proportion of different types of white blood cells; increased neutrophils suggest bacterial infection, while increased lymphocytes suggest viral infection.
  • Red Blood Cell (RBC) Count : Assesses the number of red blood cells, which can be affected by chronic illness.
  • Hemoglobin and Hematocrit : Measure of the oxygen-carrying capacity of the blood; low levels can indicate anemia.
  • Platelet Count : Assesses blood's clotting ability; low levels can indicate a problem with bone marrow or an autoimmune condition. 2. Blood Cultures
  • Procedure : Blood samples are taken and incubated to allow any bacteria or fungi to grow.
  • Indications : Used when sepsis, endocarditis, or other systemic infections are suspected.
  • Interpretation : Positive culture identifies the causative organism and guides antibiotic therapy. 5. Inflammatory Markers
  • C-Reactive Protein (CRP) : Elevated levels indicate inflammation or infection.
  • Erythrocyte Sedimentation Rate (ESR) : Elevated levels suggest inflammation, infection, or malignancy. 6. Liver Function Tests (LFTs) Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) : Elevated levels indicate liver damage. Bilirubin : High levels can indicate liver dysfunction or hemolysis. Alkaline Phosphatase (ALP) : Elevated levels can indicate bile duct obstruction or bone disease. 7. Renal function test
  • Blood Urea Nitrogen (BUN) and Creatinine :

Elevated levels indicate impaired kidney function.

  • Electrolytes : Imbalances can indicate renal dysfunction or dehydration.

8. Imaging Studies

  • Chest X-ray : To detect pneumonia, tuberculosis, or other chest infections.
  • Abdominal Ultrasound : To assess for abscesses, organomegaly, or other abnormalities.
  • CT Scan/MRI : Advanced imaging for detailed evaluation of suspected intra-abdominal or intracranial infections or malignancies. 9. Specific Serological Tests
  • Viral Serologies : Tests for specific viral infections (e.g., HIV, hepatitis, Epstein-Barr virus).
  • However, in bacterial infections, the withholding of antipyretic therapy can be helpful in evaluating the effectiveness of a particular antibiotic, especially in the absence of positive cultures of the infecting organism, and the routine use of antipyretics can mask an inadequately treated bacterial infection. Withholding antipyretics in some cases may facilitate the diagnosis of an unusual febrile disease.
  • Oral aspirin and NSAIDs effectively reduce fever but can adversely affect platelets and the gastrointestinal tract. Therefore, acetaminophen is preferred as an antipyretic. In hyperpyrexia, the use of cooling blankets facilitates the reduction of temperature; however, cooling blankets should not be used without oral antipyretics. In hyperpyretic patients with CNS disease or trauma (CNS

bleeding), reducing core temperature mitigates the detrimental effects of high temperature on the brain

  • Treat the specific disease. Reference : 21st edition of "Harrison's Principles of Internal Medicine”