It is rainy season again,and for us doctors it is usually a busy time. Out Patient Clinics and Hospital wards fill up with patients having various kinds of fevers.
Being specialised in Internal Medicine I get lot of referrals of patients with undiagnosed fevers.It is a trying time as in many cases the initial examination and lab tests may not give you a definite diagnosis.And always the patient and /or his relatives want me to say a clear cut cause for the fever at first consultation itself or at least with in a day.
Many of the serology tests become positive only after a few days and the clinician have to depend up on his clinical judgement and experience to come to a possible diagnosis and start treating the patient. For this history of the illness is very important.Most often the patient do not realise it and is not very forthcoming when asked persistent questions about the chronology of the events. Information like whether the fever started as low grade or high grade,whether there was shivering of the whole body at the onset,what other symptoms accompanies the fever etc are very important in arriving at a diagnosis.In many cases the answers to the above questions determine the initial treatment as there may not be any other clue in physical examination.Finding out the correct cause of fever is almost like a detective work.Many clues may be there but some may mislead you to a wrong diagnosis. This challenge of Fever of Unknown origin is one of the most interesting aspect of the professional life of a doctor like me