Evening rise of temperature differential diagnosis

Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy. The symptom of night sweats is commonly encountered in clinical medicine, but there are no data regarding its actual frequency. Night sweats has been defined as drenching sweats that require the patient to change bedclothes. Harrison's Principles of Internal Medicine, 13th ed. CD-ROM, and the January 1999 Physicians' Desk Referenc...

By Richard Hawkins, MACS Contributor Temperature testing to diagnose a mobile A/C repair, requires some detective work. Last week we closed our blog post with a discussion about an orifice tube system. The evaporator outlet temperature was about 20° warmer than the inlet. We mentioned that this could be an indication of a restricted orifice tube or a refrigerant undercharge. In applying this to diagnostics, it is important not only to understand what this represents, but also why. Going back to our description of orifice tube system operation, it was illustrated that in a properly charged, properly functioning orifice tube system, the evaporator will be full of liquid refrigerant. Also, the accumulator will have about a 40% to 50% liquid level in it. As a result, the evaporator inlet and outlet temperature should be about the same. You’ll find the refrigerant is boiling (changing state) in the accumulator and there is no superheating of refrigerant taking place in the evaporator. This contrasts with an expansion valve system where the expansion valve function prevents the evaporator from becoming fully flooded. The refrigerant boils in the evaporator and thus a certain amount of refrigerant superheating is maintained. The lower the liquid level is in an evaporator, the greater the temperature differential will be between the inlet and outlet. A temperature differential of about 20° indicates a low evaporator liquid level. See picture #1 below. A temperature differential li...

• Bleeker-Rovers CP, Vos FJ, de Kleijn EM, Mudde AH, Dofferhoff TS, Richter C, et al. A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine (Baltimore). 2007 Jan. 86(1):26-38. • Fusco FM, Pisapia R, Nardiello S, Cicala SD, Gaeta GB, Brancaccio G BMC Infect Dis. 2019;19(1):. Published . doi:10.1186/s1. Fever of unknown origin (FUO): which are the factors influencing the final diagnosis? A 2005–2015 systematic review. BMC Infectious Diseases. 2019 Jul 22. 19:653. • Ergönül O, Willke A, Azap A, et al. Revised definition of 'fever of unknown origin': limitations and opportunities. J Infect. 2005 Jan. 50(1):1-5. • Cunha BA. Fever of Unknown Origin. New York, NY: Informa Healthcare; 2007. • Speaker SL, Pfoh ER, Pappas MA, Hu B, Rothberg MB. Oral Temperature of Noninfected Hospitalized Patients. JAMA. May 11, 2021. 325(18):1899–1901. • Obermeyer Z, Samra JK, Mullainathan S. Individual differences in normal body temperature: longitudinal big data analysis of patient records. BMJ. 2017 Dec 13. 359:j5468. • Durack DT, Street AC. Fever of unknown origin–reexamined and redefined. Curr Clin Top Infect Dis. 1991. 11:35–51. • Mulders-Manders C, Simon A, Bleeker-Rovers C. Fever of unknown origin. Clinical Medicine. 2015 Jun 1. 15:280-284. • Pedersen TI, Roed C, Knudsen LS, Loft A, Skinhoj P, Nielsen SD. Fever of unknown origin: a retrospective study of 52 cases with evaluation of the diagnostic utility of FDG-PET/CT. Scand J In...

Shivering helps the body warm itself. When you shiver, your muscles contract and relax in rapid succession, and all those little movements can create heat. It’s an involuntary response triggered by your immune system reacting to an infection or a cold environment. An increase in body temperature can help your body fight infections because infections don’t survive as well above your normal temperature of The part of your brain that sets your body’s temperature is called the hypothalamus. When the body has an infection, the hypothalamus responds by moving the “set point” for a higher temperature. The muscles in your body respond by contracting and relaxing faster, which helps your body reach this higher temperature more quickly. Once your body temperature reaches its new set point, your shivering should stop. Other conditions, such as a sudden drop in your Additionally, certain types of anesthesia can interfere with your body’s usual temperature regulation system. When paired with a cool operating room environment, a decrease in body temperature can lead to shivering. Can you have a fever without shivering? You may have a fever without shivering and the chills, too. Conditions that may trigger a fever include: • • medications, such as certain antibiotics or blood pressure-lowering drugs • some inflammatory conditions, such as • certain immunizations, including Not every fever needs treatment. According to This treatment also applies to babies between 3 and 6 months old, as l...

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Your healthcare provider will compile a differential diagnosis, which is a list of conditions that share the same symptoms to help make a final diagnosis. The differential diagnosis will direct your healthcare provider to offer tests to rule out conditions and lead them to find the cause of your symptoms. Overview What is a differential diagnosis? When you visit your healthcare provider with symptoms, they will begin a process to diagnose your condition. Since there are a lot of different conditions that often share similar symptoms, your provider will create a differential diagnosis, which is a list of possible conditions that could cause your symptoms. A differential diagnosis is not your official diagnosis, but a step before determining what could cause your symptoms. What does my healthcare provider’s diagnostic process look like? There are several steps your healthcare provider will take to make an accurate diagnosis including: • Asking questions about your symptoms. • Reviewing your medical history. • Performing a physical examination. • Creating a differential diagnosis. • Ordering additional tests. • Reviewing test results and symptoms. • Making a diagnosis. When is a differential diagnosis performed? A differential diagnosis occurs when your symptoms match more than one condition and additional tests are necessary before making an accurate diagnosis. Tests will narrow down potential conditions on your healthcare provider’s differential diagnosis list. Test Details...