Associated findings


  • Not always due to hepatitis or cholangitis, jaundice can be due to non-specific complication of bacteremia (reactive hepatopathy termed by osler)

Relative bradycardia

  • Predicted HR = (Degree celcius X 10) – 320
  • Clinical utility is quite limited

Dry skin

  • Anhidrosis occurs late in heat stroke. The more sensitive finding is ABNORMAL mental status

Extreme hypothermia or hyperthermia

  • Worse prognosis
  • Extreme pyrexia often is due to GN bacteria infection/problems with temperature regulation eg heat stroke

Fever patterns

  • Due to use of antipyretics, limited clinical utility EXCEPT
    – Typhoid fever
    – Malaria
    – Dengue
  • Finding of unusually fever after antibiotics, consider
    – other diagnosis eg malignancy OR
    – resistant bacteria/wrong antibiotics/abscess


Steven McGee. Evidence Based Physical Diagnosis. Pg 174- 186


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