Due to the advances in imaging and diagnostic procedures, differential diagnoses for fever of unknown origin can usually be narrowed down. However, when a patient does present with fever and no clear origin, it is truly a challenge to locate the inflammation or infection in a timely manner so that focused treatment can be employed.

Due to the advances in imaging and diagnostic procedures, differential diagnoses for fever of unknown origin can usually be narrowed down. However, when a patient does present with fever and no clear origin, it is truly a challenge to locate the inflammation or infection in a timely manner so that focused treatment can be employed.

Due to the advances in imaging and diagnostic procedures, differential diagnoses for fever of unknown origin can usually be narrowed down. However, when a patient does present with fever and no clear origin, it is truly a challenge to locate the inflammation or infection in a timely manner so that focused treatment can be employed.

DQ Question

The 40-year patient presented with an oral temperature of 101.5, Heart rate of 72, and RR of 28. These signs quickly allow a healthcare professional to understand that a patient is suffering from acute fever (Wright & Auwaerter, 2020). The presentation of a fever of unknown origin (FOU) is known by rigors shaking. The etiology mainly includes infections, especially atypical mycobacterial infections. The common risk factors of FOU may be from the environment, society or family. Other risk factors are family history, radiation exposure, history of prior malignancies, HIV infection, alcohol use and travel to endemic destination. It common differential diagnosis include military TB, Q fever and amebiasis (Haidar & Singh, 2022).

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The typical diagnostic work-up test done on a patient with FUO include biopsies of lymph nodes, liver, bone marrow, epididymal nodule, and temporal artery. The treatment of FOU is guided by the final diagnosis, especially when healthcare professionals have failed to determine the cause of the fever. In such cases, antipyretic drugs can be prescribed for the patient. However, caution should be taken in avoiding corticosteroids in the absence of diagnosis at an early age (Wright & Auwaerter, 2020). When all examinations have been done on a patient but do not lead to the desired outcome, further investigations should be undertaken when the patient continues deteriorating health. There is no single treatment plan for FUO give that it has various possible etiologies. The most significant approach is to investigate and rule out any possible diagnoses. Specific treatment need to commence one effective diagnosis have been made on the patient. In the treatment plan, empiric antibiotics should not be indicated unless the patient is neutropenic. This is because antibiotics may delay diagnosis of some occult infections.

References

Haidar, G., & Singh, N. (2022). Fever of unknown origin. New England Journal of Medicine, 386(5), 463-477. DOI: 10.1056/NEJMra2111003

Wright, W. F., & Auwaerter, P. G. (2020, May). Fever and fever of unknown origin: review, recent advances, and lingering dogma. In Open Forum Infectious Diseases (Vol. 7, No. 5, p. ofaa132). US: Oxford University Press. https://doi.org/10.1093/ofid/ofaa132

please answer DQ in full

Due to the advances in imaging and diagnostic procedures, differential diagnoses for fever of unknown origin can usually be narrowed down. However, when a patient does present with fever and no clear origin, it is truly a challenge to locate the inflammation or infection in a timely manner so that focused treatment can be employed.

You are the AGACNP hospitalist provider tasked with admitting the following patient to the hospital. The patient is:

1. A 40-year-old, Hispanic, developmentally delayed, female from a local long-term care center with early dementia, DM-2 (insulin dependent), neurogenic bladder, hypertension, and systolic dysfunction (EF 30%) due to ischemic cardiomyopathy.
2. Brought by emergency medical transport to the emergency department with altered mental status and the following vital signs: oral temp is 101.5, HR 72, RR=28, and oxygen saturation on room air is 88%.
3. Currently on prednisone 20 mg daily for temporal arteritis, and Coreg 12.5 mg BID, Namenda 10 mg daily, Lasix 40 mg daily, Levemir 20 units SQ BID, metformin 500 mg BID, and sliding scale insulin.

Explain the presentation, etiology, risk factors, common differential diagnosis, typical diagnostic work-up, treatment plan (based on current clinical guidelines and evidence-based therapy), preventative measures (if any), and additional information that would be important to the geriatric population with regard to fever of unknown origin. Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

minimum 250 words and two sources thank you