What are the causes of fever and headache?

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Last updated: March 10, 2025View editorial policy

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Differential Diagnosis for Fever and Headache

Single Most Likely Diagnosis

  • Viral upper respiratory infection (e.g., common cold, influenza): This is the most common cause of fever and headache in the general population, often presenting with additional symptoms such as cough, sore throat, and runny nose.

Other Likely Diagnoses

  • Sinusitis: An infection or inflammation of the sinuses can cause fever, headache (often localized to the face), and nasal congestion.
  • Meningitis: Although less common, meningitis is a significant concern, especially in young adults and those with compromised immune systems, presenting with fever, headache, stiff neck, and potentially altered mental status.
  • Tension headache: While not typically associated with fever, tension headaches can be exacerbated by viral infections and may present with a low-grade fever.
  • Influenza: Similar to the common cold but often more severe, influenza can cause high fever, headache, and significant fatigue.

Do Not Miss Diagnoses

  • Subarachnoid hemorrhage: A life-threatening condition that requires immediate medical attention, presenting with a sudden, severe headache (often described as "the worst headache of my life") and possibly fever if there's associated infection or inflammation.
  • Encephalitis: An inflammation of the brain tissue, usually caused by viral infections, which can present with fever, headache, confusion, and altered mental status.
  • Brain abscess: A rare but potentially deadly condition where an abscess forms in the brain, often presenting with fever, headache, and focal neurological deficits.
  • Meningoencephalitis: An infection that affects both the meninges and the brain tissue, which can present with fever, headache, stiff neck, and altered mental status.

Rare Diagnoses

  • Temporal arteritis: An inflammation of the blood vessels in the head, more common in older adults, which can cause fever, headache, and visual disturbances.
  • Neurosyphilis: A complication of syphilis infection that can affect the central nervous system, presenting with a variety of symptoms including fever and headache.
  • Cerebral malaria: A severe complication of malaria infection, which can cause fever, headache, and altered mental status, particularly in travelers to endemic areas.
  • Histoplasmosis: A fungal infection that can cause fever, headache, and respiratory symptoms, more common in immunocompromised individuals or those exposed to contaminated soil.

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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