Obligatory medical device diagnostics
- Temperature measurement with a clinical thermometer – most accurate is rectal measurement, i.e., in the anus (measurement time: 5 min.) (gold standard); measurement can also be oral, i.e., under the tongue, axillary, i.e., under the armpit (measurement time: 10 min.), or auricular, i.e., in the ear (measurement error possible due to earwax); repeated fever measurements: 6 times/day, fever log if necessary.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Sonography (ultrasonography)
- Abdominal ultrasonography (ultrasound examination of the abdominal organs) – standard diagnostics in cases of unclear cause of chills; in cases of fever after a stay the tropics or subtropics, especially with regard to an amoebic liver abscess.
- Arthrosonography (ultrasound examination of joints) – in arthrosonography, both the soft tissues and superficial areas of the bones of a joint can be displayed (implementation, for example, in unclear joint swelling); if necessary, puncture of the joint under sonographic view.
- Pleural sonography (ultrasound examination of the pleura (pleura) and pleural space) – for the detection (detection) of a pleural effusion.
- X-ray of the thorax (X-ray thorax/chest), in two planes – for suspected respiratory infections [pulmonary infiltrate?]
- X-ray of the paranasal sinuses, teeth.
- Computed tomography of the thorax / chest (thoracic CT) – if systemic diseases or tumors are suspected or if the fever is unclear.
- Computed tomography of the abdomen (abdominal CT) – for example, to exclude intra-abdominal abscesses or retroperitoneal lymph nodes; in the case of unclear fever.
- Magnetic resonance imaging (MRI) – e.g., in V. a. osteomyelitis (bone marrow inflammation).
- Positron emission tomography–computed tomography (PET-CT) – diagnostic step of the third phase; fluorodeoxyglucose PET procedure has a sensitivity (percentage of diseased patients in whom the disease is detected by the use of the procedure, i.e., a positive finding occurs) of 92% and a specificity (probability that actually healthy people who do not have the disease in question are also detected as healthy in the test) of 78% in the clarification of unclear fever.
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – in suspected cases of infective endocarditis (endocarditis).
- (Transesophageal) echocardiography (TEE; echo; cardiac ultrasound) – to detect possible valvular vegetations and valve destruction.
