Medical history (history of illness) represents an important component in the diagnosis of fever. Family history
- What is the general health of your family members?
- Infectious diseases in the patient’s environment?
- Ethnicity (belonging to an ethnic group)?
Social history
- What is your profession?
- What hobbies (eg hunters) do you have?
- When and where were you last on vacation? [If travel: see below travel history]
Current medical history/systemic medical history (somatic and psychological complaints).
- How long has the fever been present?
- Less than 7 days
- Longer than 7 days and unclear cause
- How high is the fever?
- Fever pattern is to be documented:
- Is it steady, fluctuating, or undulating?
- Are there any time of day dependencies?
- Do you have chills?
- Do you have night sweats?
- Are there any accompanying symptoms?
- Rash
- Diarrhea
- Cough
- Pain
- Do you feel sick?
- Do you have headaches/limb pain?
- Have you noticed any lymph node enlargements?
- If the patient is a newborn:
- Was there fever* , positive smears* , or premature rupture of membranes* on the part of the mother?
- Is there prematurity* ?
- Have you had animal contact, tick exposure, insect bites?
Vegetative anamnesis including nutritional anamnesis.
- Have you lost body weight unintentionally?
- Has your appetite changed?
- Have you noticed any changes in bowel movements and/or urination?
- Do you smoke? If so, how many cigarettes, cigars, or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
Self-history
- Pre-existing conditions (congenital heart disease* (e.g., valvular vitiation); congenital immunodeficiency disorders* (e.g., antibody deficiency); number and severity of infections; malignancies* ; blood disorders and impaired splenic function* ; immunodeficiencies* ; infectious diseases).
- Sexual history
- Sexual habits (heterosexuality, homosexuality, bisexuality)?
- Frequency and number of sexual contacts?
- Do you engage in anal intercourse/anal sex? If yes, receptive or insertive or passive or active?
- Do you empty your urinary bladder after sexual intercourse?
- Do you use contraceptives? If yes, which ones (e.g., condoms?, vaginal diaphragm?, hormonal contraceptives?).
- Pregnancy history (if the patient is a newborn).
- Surgeries (splenectomy/spleen removal?, organ transplant?).
- Injuries
- Allergies
- Vaccination status, malaria prophylaxis
Drug history
Drug fever (synonym: drug fever) – mainly due to hypersensitivity syndromes; fever occurs in this case relatively shortly after the first drug intake and subsides within 72 hours after discontinuation of the drug; examples:
- Analgesics
- Antibiotics
- Aminoglycoside antibiotics (streptomycin).
- Antibiotic from the group of polymyxins (colistin).
- Cephalosporins
- Glycopeptide antibiotics (vancomycin)
- Penicillins
- Sulfonamides
- Antiepileptic drugs (barbiturates and phenytoin).
- Antihistamines (H1 and H2 blockers).
- Antihypertensives (dihydralazine, methyldopa).
- Antipsychotics (depressant psychotropic drugs).
- Barbiturates
- Biologics (infliximab, filgrastim, etc.)
- Diuretics
- Hormones
- Thyroid hormones (L-thyroxine),
- Neuroleptics
- Non-steroidal anti-inflammatory drugs (including salicylates).
- Sedatives
- Centrally acting drugs (e.g., halothane, succinylcholine).
Travel history
- Itinerary: places of stay; or escape route with duration and circumstances of stay.
- When did you travel. [due toincubation period:
- Bacterial infections usually have a short incubation period, so associated diseases such as.B. cholera, typhoid fever, sigellosis, rickettsiosis four weeks after a return are unlikely to be
- Helminths such as intestinal tropical diseases or worm diseases: at least seven weeks until the onset of the disease]
- Duration of stay
- How did you spend the night?
- Outdoors
- In the hotel (with or without open windows).
- Are there specific risk factors present? Such as:
- Consumption of raw dairy products (brucellosis, tuberculosis).
- Contact with diseased persons
- Contact with prostitutes (HIV infection, hepatitis B and C, syphilis).
- Contact with inland waters (Katayama syndrome)/contact with fresh water (schistosomiasis, leptospirosis).
- Blood transfusions (HIV infection, hepatitis B and C, malaria),
- Animal contacts (brucellosis, leptospirosis, Q fever, rabies, tularemia).
- Open drinking water systems (legionellosis, leptospirosis).
- Visits to caves (Ebola, histoplasmosis; Marburg and Ebola fevers).
- Have they received medical treatment in the tropics?
- What did you do in the tropics?
- What prophylactic measures did they perform?
In unclear cases, consultation with a tropical institute can be made.
When must a child with fever to the doctor? *
Babies with fever generally belong to the pediatrician and adolescent doctor. Older children should be presented to him in the following cases:
- The fever rises above 38.5 °C.
- The fever persists for more than three days.
- The child refuses to drink, loses fluid and becomes dehydrated.
- The child is well, but vomiting lasts longer than twelve hours (if the child is not well, earlier to the doctor!).
- The child is well, but diarrhea lasts longer than two days (if the child is not well, earlier to the doctor!).
- The child has severe abdominal pain or cramps.
- The pain is getting worse despite treatment.
- The child convulses.
- The child has a skin rash or shows symptoms of ear pain or breathing difficulties.
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)