Differential Diagnosis for Intermittent Chronic Fevers
Single Most Likely Diagnosis
- Tuberculosis (TB): TB is a common cause of chronic fever, especially in endemic areas. It can present with intermittent fevers, night sweats, and weight loss. The diagnosis is often made through a combination of clinical presentation, imaging, and microbiological tests.
Other Likely Diagnoses
- Endocarditis: Infective endocarditis can cause intermittent fevers, especially if the infection is localized to the heart valves. It's more common in individuals with pre-existing heart conditions or intravenous drug users.
- Osteomyelitis: Chronic osteomyelitis, an infection of the bone, can cause intermittent fevers, pain, and swelling over the affected bone.
- Chronic Pyelonephritis: This is a type of urinary tract infection that involves the kidneys. It can cause recurrent or intermittent fevers, flank pain, and urinary symptoms.
- Autoimmune Disorders (e.g., Rheumatoid Arthritis, Lupus): Certain autoimmune diseases can cause intermittent fevers as part of their systemic manifestations.
Do Not Miss Diagnoses
- Malignancies (e.g., Lymphoma, Leukemia): Some cancers, particularly hematological malignancies, can present with intermittent fevers as an early symptom. Missing these diagnoses can significantly impact prognosis and treatment outcomes.
- Abscesses (e.g., Liver, Brain): Abscesses in critical areas can be life-threatening if not promptly diagnosed and treated. They may cause intermittent fevers, depending on the location and the body's response to the infection.
- Sepsis: Recurrent or intermittent episodes of sepsis, especially in patients with underlying conditions (e.g., diabetes, immunocompromised states), can be life-threatening and require immediate medical attention.
Rare Diagnoses
- Whipple's Disease: A rare, systemic bacterial infection that can cause fever, weight loss, diarrhea, and arthralgias. It's often diagnosed through small bowel biopsy.
- Brucellosis: A zoonotic infection that can cause intermittent fevers, malaise, and weight loss. It's more common in individuals who work with animals or consume unpasteurized dairy products.
- Relapsing Fevers (e.g., Tick-Borne Relapsing Fever, Louse-Borne Relapsing Fever): These are caused by different species of Borrelia and are transmitted by ticks or lice. They cause recurring episodes of fever, often with a distinctive periodicity.