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Night Sweats

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Night Sweats

  • History
  1. Infectious disease exposure (HIV, Tuberculosis)
  2. Travel (Coccidioidomycosis, Malaria)
  3. Full Review of Systems for comorbid conditions
    1. Evaluate for causes below
  • Exam
  • Focused on suspected causes
  • Evaluation
  1. Step 1
    1. Evaluate for causes suggested by history and exam
  2. Step 2
    1. Complete Blood Count (CBC)
    2. Chest XRay
    3. Purified Protein Derivative (PPD)
  3. Step 3
    1. HIV Test
    2. Erythrocyte Sedimentation Rate (ESR)
  4. Step 4: Gastroesophageal Reflux Empiric Mangement
    1. Proton Pump Inhibitor trial
  5. Step 5: Chart for nocturnal fever spikes
    1. Obtain Blood Cultures if positive
    2. Include atypical organisms
      1. Haemophilus
      2. Actinobacillus
      3. Cardiobacterium
      4. Eikenella
      5. Kingella
  6. Step 6
    1. Chest CT
    2. Abdominal CT
    3. Bone Marrow Biopsy
  7. Other tests to consider
    1. Follicle Stimulating Hormone (FSH)
      1. Early menopausal symptoms suspected
  8. References
    1. Vera (2003) Am Fam Physician 67(5):1019-24 [PubMed]