Fever without a focus
Separate the septic patient from the stable one, take an exposure history that finds Australian zoonoses and travel infections, and work up fever of unknown origin in order.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Fever without a focus is fever with no localising symptoms or signs after a first history and examination. Most turn out to be infection, but drug fever, VTE, malignancy and inflammatory disease cause a large share.
- First question: is this sepsis? If yes, take cultures and give antibiotics now (Surviving Sepsis 2026). If no, take time to find the cause.
- The exposure history finds most of the Australian answers: travel, animals, occupation, water, insects, sex, drugs and devices.
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Sources
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026Society of Critical Care Medicine and European Society of Intensive Care Medicine, 2026
- Sepsis Clinical Care StandardAU/NZAustralian Commission on Safety and Quality in Health Care, 2022
- Therapeutic Guidelines: Antibiotic. Sepsis and septic shock, fever in returned travellers, zoonosesAU/NZTherapeutic Guidelines Limited (eTG complete), 2025 to 2026 staged update (topic version not verified)
- Fever of unknown originNew England Journal of Medicine (Haidar and Singh), 2022
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy