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High fever and slow pulse
    Differential Diagnosis[Top] [Nav]
drug fever, typhoid fever, yellow fever, other infectious and non-infectious conditions
    Discussion -- not available online[Top] [Nav]
    Update Comments[Top] [Nav]
  • A hot drink can quickly raise oral temperature up to 3°F, but 5 minutes later the rise is only 0.5°. Drinking ice water will lower the oral temperature up to 1°F for 5 minutes. [103]
  • "Before facing the diagnostic enigma so often presented by a case of `F.U.O.,' one should be sure that the `F' component is present." [104]
  • In cases of fever of unknown origin, "relative bradycardia may be useful when present, although it is associated with a substantial differential diagnosis, including typhoid fever, legionnaire's disease, psittacosis, leptospirosis, drug fever, brucellosis, subacute necrotising lymphadenitis, neoplasm and factitious fever." [108]
  • Nice summary of relation between temperature and heart rate. Chapter 5 of this book, by the way, is an interesting history of clinical thermometry. [109]
  • "In healthy young people, the heart rate may increase by 8.5 beats per minute for each 1°C increase in temperature during infection, and by 25 beats per minute per degree Celsius in experimental hyperthermia." [110]
    Footnotes in Print Edition[Top] [Nav]
    (1) Implications of fever in the critical care setting.
  Cunha BA, Digamon-Beltran M, et al.   Heart Lung 1984 Sep;13(5):460-5.  Pubmed  Similars
    (2) Drug fever. The importance of recognition.
  Cunha BA.   Postgrad Med 1986 Oct;80(5):123-9.  Pubmed  Similars
    (3) Yellow Fever.
  Strode GK (ed). New York: McGraw-Hill, 1951: 390-396, 416.
    (4a) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 25-1985. A 27-year-old man with recurrent bleeding from the left kidney for 13 years.
  N Engl J Med 1985 Jun 20;312(25):1623-31.  Pubmed  Similars
    (4b) [Mediterranean boutonneuse fever. Apropos of 154 recent cases].
  Raoult D, Jean-Pastor MJ, et al.   Ann Dermatol Venereol 1983;110(11):909-14.  Pubmed+Abstract  Similars
    (5) [This footnote was a comment, not a reference.]
    (6) Stedman's Medical Dictionary.
  Stedman TL. Baltimore: Williams & Wilkins, 1976: 'rule, Liebermeister'.   Amazon.com
    New References[Top] [Nav]

Measuring temperature
    101.Effects of anatomic site, oral stimulation, and body position on estimates of body temperature.
  Rabinowitz RP, Cookson ST, et al.   Arch Intern Med 1996 Apr 8;156(7):777-80.  Pubmed+Abstract  Similars
    102.Effect of tachypnea on the estimation of body temperature by an oral thermometer.
  Tandberg D, Sklar D.   N Engl J Med 1983 Apr 21;308(16):945-6.  Pubmed  Similars
    103.Smoking, hot and cold drinks, pulse, and temperature [letter].
  Graham B, Theil GB, et al.   Ann Intern Med 1983 Apr;98(4):559-60.  Pubmed  Similars
    104.Factitious fever.
  Petersdorf RG, Bennett IL Jr.   Ann Int Med. 1957;46:1039-1062.

Conditions with temperature-pulse dissociation
    105.Visceral infection caused by Leishmania tropica in veterans of Operation Desert Storm [see comments].
  Magill AJ, Grogl M, et al.   N Engl J Med 1993 May 13;328(19):1383-7.  Pubmed+Abstract  Similars
    106.Human leptospirosis.
  Edwards GA, Domm BM.   Medicine. 1960;39:117-156.
    107.Drug fever: a critical appraisal of conventional concepts. An analysis of 51 episodes in two Dallas hospitals and 97 episodes reported in the English literature.
  Mackowiak PA, LeMaistre CF.   Ann Intern Med 1987 May;106(5):728-33.  Pubmed+Abstract  Similars
    108.Fever of unknown origin [see comments].
  Arnow PM, Flaherty JP.   Lancet 1997 Aug 23;350(9077):575-80.  Pubmed  Similars

    109.Fever: Basic Mechanisms and Management.
  Mackowiak P (ed). New York; Raven, 1991: 155-157.   Amazon.com
  Simon HB.   N Engl J Med 1993 Aug 12;329(7):483-7.  Pubmed  Similars
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    ©1986-2000 John Sotos, MD. All rights reserved.  Last updated 16:33 PDT on July 4, 2000.[Top]

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