Differential Diagnosis for Rigors
Rigors are a symptom characterized by intense shivering or shaking, often accompanied by a fever. The following differential diagnosis is organized into categories to help guide the diagnostic process.
- Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): A common cause of rigors, especially in older adults or those with underlying medical conditions. UTIs can lead to bacteremia, which may cause rigors.
- Other Likely Diagnoses
- Pneumonia: Both community-acquired and hospital-acquired pneumonia can cause rigors, especially if the infection is severe or caused by a virulent pathogen.
- Sepsis: A systemic infection that can cause rigors, along with other symptoms such as fever, tachycardia, and hypotension.
- Malaria: In areas where malaria is endemic, it is a common cause of rigors, especially in travelers or individuals who have not taken prophylactic measures.
- Influenza: Certain strains of influenza can cause rigors, especially during the initial stages of the illness.
- Do Not Miss Diagnoses
- Endocarditis: Although less common, endocarditis is a serious condition that can cause rigors, along with other symptoms such as fever, heart murmur, and embolic phenomena.
- Meningitis: Bacterial meningitis can cause rigors, along with other symptoms such as headache, stiff neck, and altered mental status.
- Severe Bacterial Infections (e.g., septic arthritis, osteomyelitis): These infections can cause rigors, along with other symptoms such as localized pain, swelling, and redness.
- Rare Diagnoses
- Brucellosis: A zoonotic infection that can cause rigors, along with other symptoms such as fever, fatigue, and weight loss.
- Lymphoma: Certain types of lymphoma can cause rigors, along with other symptoms such as fever, night sweats, and weight loss.
- Drug Fever: Certain medications can cause rigors, along with other symptoms such as fever and rash.
Each of these diagnoses has a unique set of clinical features and risk factors that can help guide the diagnostic process. A thorough history, physical examination, and laboratory tests are essential to determine the underlying cause of rigors.