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Last updated: July 23, 2025View editorial policy

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Differential Diagnosis for Chills

  • Single most likely diagnosis
    • Influenza: This is often the first consideration for chills, especially during flu season, due to its high prevalence and the common presentation of chills along with fever, cough, and body aches.
  • Other Likely diagnoses
    • Pneumonia: Chills can be a symptom of pneumonia, particularly bacterial pneumonia, which often presents with high fever, chills, and cough.
    • Urinary Tract Infection (UTI): Especially in older adults or those with certain risk factors, UTIs can cause chills, fever, and dysuria.
    • Malaria: In travelers to or residents of endemic areas, malaria should be considered, as it classically presents with cyclical fevers and chills.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Sepsis: Although not the most common cause of chills, sepsis is a life-threatening condition that requires immediate recognition and treatment. It can present with fever, chills, tachycardia, and hypotension.
    • Meningitis: This is an infection of the meninges that can present with fever, chills, headache, and stiff neck. It's critical to diagnose and treat promptly to prevent serious complications or death.
    • Endocarditis: Infective endocarditis, an infection of the heart valves, can cause fever, chills, and may have a subtle presentation, making it easy to miss but critical not to.
  • Rare diagnoses
    • Brucellosis: A zoonotic infection that can cause undulant fever, chills, and malaise, typically in individuals who work with animals or consume unpasteurized dairy products.
    • Lymphoma: Certain types of lymphoma can present with systemic symptoms including fever, chills, and night sweats.
    • Tuberculosis: While more commonly associated with chronic symptoms, TB can occasionally present acutely with fever, chills, and other systemic symptoms, particularly in immunocompromised individuals.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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