| | Infections | Noninfectious inflammatory disorders | Malignancies | Miscellaneous |
| Constitutional symptoms and signs |
| Triad of night sweats, weight loss, and anorexia | - Tuberculosis (pulmonary or extrapulmonary)
- Endocarditis
- Disseminated mycobacterial infection (miliary tuberculosis, nontuberculous mycobacteria)
- Disseminated fungal infection (eg, histoplasmosis, blastomycosis, coccidioidomycosis)
- Brucellosis
- Typhoid/enteric fever
- Q fever
- Visceral leishmaniasis
| - Vasculitis (eg, ANCA-associated, giant-cell arteritis, polyarteritis nodosa)
- Tumor necrosis factor receptor-1 associated periodic syndrome (TRAPS)
| - Lymphoma
- Renal cell carcinoma
- Metastatic cancer
| - Castleman disease
- Atrial myxoma
- Hyperthyroidism (fever is an uncommon feature)
- Treatment of bladder cancer with intravesicle bacillus Calmette-Guerin (BCG)
- Hemophagocytic lymphohistiocytosis
|
| Head and neck |
| Headache | - Mononucleosis (Epstein-Barr virus, acute HIV syndrome, cytomegalovirus, Toxoplasma gondii)
- Chronic meningitis (numerous causes)
- Typhoid/enteric fever
- Acute HIV syndrome
- Malaria
- Bartonella quintana infection
- Leptospirosis (immune phase of illness)
- Scrub typhus
- Epidemic typhus
- Murine typhus
- Q fever
- Schistosomiasis
- Rat-bite fever
| - Giant-cell arteritis
- Familial Mediterranean fever
| | - Pheochromocytoma
- Hemolytic-uremic syndrome
- Thrombotic thrombocytopenia purpura
|
| Temporal artery tenderness | | | | |
| Transient or sustained unilateral vision loss | | - Giant-cell arteritis (transient visual loss [amaurosis fugax])
| | |
| Abnormal fundus exam | - Endocarditis (Roth spots)
- Tuberculosis (choroid tubercle)
| - Giant-cell arteritis (transient visual loss [amaurosis fugax])
| | |
| Red eye (eg, conjunctivitis, scleritis, uveitis) | - Leptospirosis (immune phase of illness)
- Murine typhus
- Endocarditis (conjunctival petechiae)
- Brucellosis
- Toxoplasma
- Tuberculosis
| - Adult-onset Still's disease
- Vasculitis (rheumatoid, ANCA-associated, polyarteritis nodosa)
- Behçet syndrome
- Systemic lupus erythematosus
- Sarcoidosis
| | - Inflammatory bowel disease
- Medications
|
| Sinus symptoms (eg, sinusitis) | - Bacterial sinusitis
- Dental infections
| - ANCA-associated vasculitis
- Sarcoidosis
| | |
| Sore throat, pharyngitis | - Mononucleosis (Epstein-Barr virus, Toxoplasma gondii)
- Gonococcal pharyngitis
- Rat-bite fever
| - Adult-onset Still's disease
- Giant-cell arteritis
- ANCA-associated vasculitis
- PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and adenitis) syndrome
- Sarcoidosis
| | |
| Poor dentition; dental pain | - Dental infection
- Sinusitis
| - Giant-cell arteritis (jaw claudication)
| | |
| Oral ulcers | - Acute HIV syndrome (acute HIV)
- Histoplasmosis
- Primary herpes simplex infection
| - Systemic lupus erythematosus
- Behçet syndrome
- ANCA-associated vasculitis
- PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and adenitis) syndrome
| | - Crohn's disease
- Cyclic neutropenia
- Medications
|
| Thyroid enlargement, tenderness, or nodule | | | | - Hyperthyroidism
- Subacute thyroiditis
|
| Lymph nodes |
| Localized lymphadenopathy | - Mononucleosis (Epstein-Barr virus, acute HIV syndrome [acute HIV], cytomegalovirus, Toxoplasma gondii)
- Tuberculosis (ie, scrofula)
- Cat-scratch disease due to Bartonella henselae
- Tularemia (typhoidal disease)
| - PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and adenitis) syndrome
| - Lymphoma
- Head and neck cancer
- Breast cancer
| - Kikuchi disease
- Castleman disease
|
| Diffuse lymphadenopathy | - Mononucleosis (Epstein-Barr virus, acute HIV syndrome [acute HIV], cytomegalovirus, Toxoplasma gondii)
- Miliary tuberculosis
- Scrub typhus
- Oroya fever
| - Systemic lupus erythematosus
- Adult-onset Still's disease
- Sarcoidosis
| - Lymphoma
- Metastatic disease
| - Castleman disease
- Medications
|
| Lungs |
| Cough +/– hemoptysis | - Mycobacterial infection (eg, tuberculosis, M. kansasii)
- Q fever
- Endemic mycoses (eg, histoplasmosis, blastomycosis, coccidioidomycosis)
- Schistosomiasis
| - ANCA-associated vasculitis
- Anti-glomerular basement membrane disease
- Systemic lupus erythematosus
| - Lung cancer
- Metastases to lung
| |
| Heart |
| New or changed murmur | | | | |
| New heart block (first-, second-, or third-degree) | - Endocarditis
- Lyme disease
| | | |
| Abdomen |
| Abdominal pain | - Common intra-abdominal conditions (eg, cholecystitis, appendicitis, diverticulitis)
- Viral hepatitis
- Liver abscess (WBC, neurtrophilia)
- Cholangitis
- Typhoid/enteric fever
- Intra-abdominal abscess
- Perihepatitis (Fitz-Hugh-Curtis syndrome in women with pelvic inflammatory disease)
- Tuberculosis
- Splenic abscess
- Coccidioidomycosis
- Tularemia
- Epidemic typhus
- Schistosomiasis
- Peritonitis in patient with cirrhosis or on peritoneal dialysis
| - Behçet syndrome
- Vasculitis (eg, polyarteritis nodosa)
- Tumor necrosis factor receptor-1 associated periodic syndrome (TRAPS)
- Familial Mediterranean fever
| | - Inflammatory bowel disease
- Splenic infarct (due to vasculitis or endocarditis)
- Hemolytic-uremic syndrome
- Thrombotic thrombocytopenia purpura
- Adrenal insufficiency
- Complications of pregnancy
- Retroperitoneal fibrosis
- Mesenteric sclerosis
- Alcoholic hepatitis
|
| Diarrhea | - Typhoid/enteric fever (constipation is more common)
- Clostridium difficile infection
- Schistosomiasis
| | | - Inflammatory bowel disease
- Medications
|
| Hepatomegaly | - Viral hepatitis
- Liver abscess (including amoebic)
- Extrapulmonary tuberculosis
- Disseminated histoplasmosis
- Q fever
- Acute toxo
- Typhoid/enteric fever
- Brucellosis
- Oroya fever
- Schistosomiasis
| - Adult-onset Still's disease
- Sarcoidosis
| - Hepatocellular carcinoma
- Liver metastases
- Hepatosplenic T-cell lymphoma
| - Castleman disease
- Treatment of bladder cancer with intravesicle bacillus Calmette-Guerin (BCG)
|
| Splenomegaly | - Mononucleosis due to Epstein-Barr virus or toxo
- Malaria
- Endocarditis (may cause splenic abscess)
- Disseminated histoplasmosis
- Typhoid/enteric fever
- Bartonella quintana infection
- Babesiosis
- Brucellosis
- Q fever
- Schistosomiasis
- Visceral leishmaniasis
| - Systemic lupus erythematosus
- Felty syndrome
- Sarcoidosis
| | - Hemophagocytic lymphohistiocytosis
- Castleman disease
|
| Genitourinary |
| Hematuria and/or flank pain | - Urinary tract infection
- Genitourinary tuberculosis
- Endocarditis
- Schistosomiasis
- Melioidosis
| - ANCA-related vasculitis
- Anti-glomerular basement membrane disease
- Systemic lupus erythematosus
| | - Hemolytic-uremic syndrome
- Thrombotic thrombocytopenia purpura
- Treatment of bladder cancer with intravesicle bacillus Calmette-Guerin (BCG)
|
| Pelvic pain | - Prostatitis in men (due to enterica gram-negative bacteria, sexually transmitted infections, tuberculosis, blastomycosis, coccidioidomycosis, melioidosis)
- Urinary tract infection
- Gynecologic infection in women, including pelvic inflammatory disease
| | - Gynecologic, urologic, or colon cancer
| - Treatment of bladder cancer with intravesicle bacillus Calmette-Guerin (BCG)
|
| Testicular swelling or tenderness | - Brucellosis
- Genitourinary tuberculosis
- Blastomycosis
- Coccidioidomycosis
- Sexually transmitted infections (eg, gonorrhea)
- Epididymitis due to enteric bacteria
| - Polyarteritis nodosa
- Behçet syndrome (genital ulcers most common)
- Familial Mediterranean fever
| | - Treatment of bladder cancer with intravesicle bacillus Calmette-Guerin (BCG)
|
| Back |
| Back pain | - Bacteremia +/– endocarditis
- Vertebral osteomyelitis (due to common bacterial causes, brucellosis, tuberculosis, blastomycosis)
| | | |
| Muscles and joints |
| Myalgias | - Endocarditis
- Acute toxo
- Bartonella quintana infection (pain in shin bones is common)
- Babesiosis
- Relapsing fever due to Borrelia spp
- Leptospirosis
- Scrub typhus
- Epidemic typhus
- Murine typhus
- Q fever
- Schistosomiasis
- Rat-bite fever
| - Vasculitis (eg, giant-cell arteritis associated with polymyalgia rheumatica)
- Systemic lupus erythematosus
- Tumor necrosis factor receptor-1 associated periodic syndrome (TRAPS)
- Familial Mediterranean fever
| | - Adrenal insufficiency
- Medications
|
| Diffuse arthralgias | - Brucellosis
- Endocarditis
- Disseminated gonococcus
- Relapsing fever due to Borrelia spp
- Q fever
- Epidemic typhus
- Schistosomiasis
- Rat-bite fever
| - Adult-onset Still's disease
- Systemic lupus erythematosus
- Vasculitis syndromes
- Familial Mediterranean fever
- Sarcoidosis
| - Multiple myeloma (pain is localized to back, neck, shoulders, pelvis, hip)
| - Adrenal insufficiency
- Medications
|
| Inflammatory arthritis | - Septic arthritis
- Brucellosis
- Parvovirus B19 infection (anemia)
- Disseminated gonococcus
- Coccidioidomycosis
- Chronic meningococcemia (mild leukocytosis, neturophila)
- Rat-bite fever
| - Rheumatoid arthritis
- Adult-onset Still's disease
- Systemic lupus erythematosus
- Behçet syndrome
- Familial Mediterranean fever
- Sarcoidosis
- Crystal-induced arthropathy (eg, gout)
| | - Inflammatory bowel disease
- Medications
|
| Neurologic |
| Recent stroke | | - Vasculitis (eg, polyarteritis nodosa)
| | |
| Peripheral neuropathy | | - ANCA-associated vasculitis
- Polyarteritis nodosa
- Systemic lupus erythematosus
| | |
| Skin |
| Maculopapular rash | - Acute HIV syndrome (acute HIV)
- Typhoid/enteric fever
- Mononucleosis due to Epstein-Barr infection (especially after treatment of penicillin)
- Scrub typhus
- Epidemic typhus
- Rat-bite fever
| - Adult-onset Still's disease (evanescent salmon-colored rash during fever)
- Systemic lupus erythematosus
| | |
| Palpable purpura | | - Vasculitis (eg, ANCA-associated vasculitis, polyarteritis nodosa)
| | |
| Petechiae, splinter hemorrhages | - Endocarditis (also can have Osler nodes or Janeway lesions on hands)
| | | |
| Erythema nodosum | - Streptococcal infection, especially pharyngitis
- Tuberculosis
- Brucellosis
- Endemic mycoses (eg, histoplasmosis, blastomycosis, coccidioidomycosis)
- Mononucleosis
| - Behçet syndrome
- Sarcoidosis
| - Lymphoma
- Leukemia
- Solid tumors
| - Inflammatory bowel disease
- Sweet syndrome
- Drug reaction
|
| Pustules | - Disseminated gonococcus
- Rickettsialpox
- African tick bite fever
- Queensland tick typhus
| | | |
| Mass, nodule, or eschar | - Blastomycosis
- Coccidioidomycosis
- Tularemia
- Scrub typhus
- Spotted fever rickettsial infections (other than Rocky Mountain spotted fever)
- Melioidosis
| | | |
