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Faget Sign - Pulse-Temperature Dissociation
Causes of Relative Bradycardia
 • Infectious Causes: Legionella, Psittacosis, Q fever, Typhoid
Psittacosis, Q fever ... , Typhoid fever, ... Typhus, Babesiosis, Malaria ... , Dengue fever, ... , Drug fever
Causes of Relative Bradycardia - Note the propensity for intracellular organisms.
Infectious: 
Legionella, Psittacosis, Q fever, Typhoid
Psittacosis, Q fever ... , Typhoid fever, ... Typhus, Babesiosis, Malaria ... , Dengue fever, ... , Drug fever
Fever Patterns - Differential Diagnosis Framework

Continuous Fever:
Temp > 38°C with only 1 degree fluctuation in 24
bacteremia • Malaria ... endocarditis, malaria ... Malaria • Lymphoma ... (Falciparum malaria ... hemolysis) • Malaria
Fever in the Returning Traveler - History
Exposure History:
 • Street foods / Local water: entenc fever,
Arthropod bites: malaria ... < 7 days: malaria ... 7-21 days: malaria ... > 21 days: malaria ... / Continuous: malaria
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 ... Babesiosis • Malaria ... • Drug Fever ... Typhoid Fever (S
Fever in Returning Travelers from Tropical Regions - Frequent Differential Diagnoses
Medical History:
 • Skin exposure to
Fever in Returning ... Symptoms: • Fever ... or symptoms - Malaria ... pulmonary embolism, malaria ... , brucellosis, malaria
Mosquito Borne Diseases
 - Dengue
 - Yellow Fever
 - Zika
 - Chikungunya
 - Malaria

- VA Joint
Dengue - Yellow Fever ... Chikungunya - Malaria
Causes of Fever of Unknown Origin (FUO) - Differential Diagnosis Algorithm
Neoplasm:
• NHL
• Hodgkin's lymphoma
• Leukemia
• Solid
Causes of Fever ... Other: • Drug fever ... • Factitious fever ... • Rheumatic fever ... Protozoa (eg. malaria
Causes of Fever of Unknown Origin (FUO) - Differential Diagnosis
 • Infection: Extrapulmonary tuberculosis, Abscess, Endocarditis,
Causes of Fever ... Lemierre's syndrome), Malaria ... Brucellosis, Q fever ... Mediterranean fever ... , Factitious fever
Fever of Unknown Origin (FUO) - Further Workup

 • CNS symptoms? Get an LP and imaging
Fever of Unknown ... Refer to your ‘Fever ... • Travel to malaria–endemic ... udaygulati #FUO #Fever