CHILLS

Ask the following questions:

1. Is there a heart murmur? The presence of a heart murmur would suggest bacterial endocarditis.
2. Is there jaundice? The presence of jaundice should suggest ascending cholangitis and cholecystitis.
3. Is there frequency or burning of urination? The presence of frequency or burning of urination should suggest pyelonephritis, perinephric abscess, and prostatic abscess.
4. Is there hepatomegaly? The presence of an enlarged liver usually without jaundice is indicative of amebic abscess. The liver may be palpable, but not significantly enlarged in subdiaphragmatic abscess.
5. Are there neurologic signs? Neurologic findings would indicate a brain abscess, sinus thrombosis, various forms of encephalitis, and epidural abscess. Don't forget that an epidural abscess of the spine may have its onset with chills. This type of abscess should be looked for in diabetics.
6. Is there cough or rales? The presence of cough or rales should prompt a search for a lung abscess, lobar pneumonia, bronchiectasis, and tuberculosis.
7. Is there bone pain or a bone mass? These findings are typical of osteomyelitis.
8. Are there no focal signs of infection? Without focal signs of infection, one should suspect septicemia, malaria, acute hemolytic anemias, relapsing fever, subdiaphragmatic abscess, and dental abscesses. However, chills may occur at the onset of any acute infection.

DIAGNOSTIC WORKUP

This is identical to the diagnostic workup for acute fever on page 168.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Chills

Read excerpts from these other book chapters related to Chills:

Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Chills

• Back to symptom: Chills: Introduction (review 714 causes)
• Next Book Extract About Chills: CHILLS (Differential Diagnosis in Primary Care)
• All Book Extracts: All Online Book Extracts for Chills

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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