Endocarditis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]

Overview

Endocarditis must be differentiated from other causes of a fever of unknown origin (FUO) such as pulmonary embolism, deep vein thrombosis, lymphoma, drug fever, cotton fever, and disseminated granulomatoses.[1]

Differential Diagnosis

Endocarditis must be differentiated from other causes of a fever of unknown origin such as:[1]

Drug Fever

A drug fever will resolve with discontinuation of the offending agent. There may be elevated urine eosinophils and a peripheral eosinophilia as well.

Cotton Fever

The symptoms of cotton fever resemble those of sepsis and patients may be initially misdiagnosed upon admission to a hospital. However sepsis is a serious medical condition which can lead to death, whereas cotton fever, if left alone, will usually resolve itself spontaneously within 12-24 hours. Symptoms usually appear with 10-20 minutes after injection and in addition to fever may include headaches, malaise, chills, nausea and tachycardia. The fever itself usually reaches 38.5 - 40.3°C (101 - 105°F) within the first hour.[2]

References

  1. 1.0 1.1 Hirschmann JV (1997). "Fever of unknown origin in adults". Clin Infect Dis. 24 (3): 291–300, quiz 301-2. PMID 9114175.
  2. Harrison DW, Walls RM (1990). ""Cotton fever": a benign febrile syndrome in intravenous drug abusers". J Emerg Med. 8 (2): 135–9. PMID 2362114.

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