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Aplastic Anemia - Overview

Who?
• M = F
• 3 peaks:	1) Childhood	2) 15-25 years	3) >60 years

What?
• Aplastic anemia
Presentation: • Fever ... and petechiae Causes ... index < 2 • EPO Level ... Anemia #oncology #hematology ... #diagnosis #management
Faget Sign - Pulse-Temperature Dissociation
Causes of Relative Bradycardia
 • Infectious Causes: Legionella, Psittacosis, Q fever, Typhoid
Psittacosis, Q fever ... , Typhoid fever, ... , Dengue fever, ... Mountain spotted fever ... , Drug fever
Faget's Sign & Liebermeister's Rule
Pulse-Temperature Dissociation
EVERY 1 F RISE IN TEMPERATURE -> HR INCREASES 8-10 BPM
INFECTIOUS
Psittacosis • Q Fever ... • Typhoid Fever ... • Drug Fever ... Typhoid Fever (S ... Dengue Fever NOTE
Causes of Relative Bradycardia - Note the propensity for intracellular organisms.
Infectious: 
Legionella, Psittacosis, Q fever, Typhoid
Causes of Relative ... , Typhoid fever, ... , Dengue fever, ... , Drug fever ... #bradycardia #Causes
Causes of Fever of Unknown Origin (FUO) - Differential Diagnosis
 • Infection: Extrapulmonary tuberculosis, Abscess, Endocarditis,
Causes of Fever ... Brucellosis, Q fever ... Malignancy: - Hematologic ... Mediterranean fever ... , Factitious fever
Childhood Immunization Schedule: Why we immunize
 • Diphtheria Toxin -> URT inflammation causes pseudomembrane with hardened
pharyngeal erythema, fever ... pharyngeal erythema, fever ... attack meninges -> Fever ... Sudden onset of fever ... pruritic rash, fever
Fever Patterns - Differential Diagnosis Framework

Continuous Fever:
Temp > 38°C with only 1 degree fluctuation in 24
Fever Patterns - ... Continuous Fever ... (Step ladder: fever ... or no fever • ... Non-Infectious Causes
Causes of Fever by System #Diagnosis #EM #IM #Fever #Differential #Ddxof
Causes of Fever ... Diagnosis #EM #IM #Fever
Hepatobiliary Manifestations of Sickle Cell Disease
Acute sickle cell hepatic crisis:
 • Fever, acute onset RUQ pain,
hepatic crisis: • Fever ... cholestasis: • Fever ... progressing to acute liver ... Liver transplant ... Hepatobiliary #hepatology
Fever of Unknown Origin (FUO) - Further Workup

 • CNS symptoms? Get an LP and imaging
Fever of Unknown ... Refer to your ‘Fever ... Liver biopsy • ... values supporting hematologic ... udaygulati #FUO #Fever