Fever: Medical History

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:

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)