Protocolo diagnóstico del síndrome febril sin focalidad en áreas geográficas de riesgo endémico de infecciones tropicales

Abstract

It is important for physicians to comprehensively approach fever, given that there is an urgent need for a diagnosis of febrile syndromes which may indicate multiple pathogens and inform decisions regarding care. The initial assessment of acute febrile syndrome must be eminently clinical, given that on most occasions, we will not have additional diagnostic methods, nor will they be necessary. A patient's outcome depends on a good initial assessment that takes into account the tropical setting.Fever is defined as the elevation of body temperature above normal limits (36.8°+0.4°C rectal, + 0.5-0.6°C axillary) due to a disequilibrium in the production (muscle, liver) and elimination of heat, taking into account a circadian rhythm with a minimum at 6:00 a.m. and a maximum at 6:00 p.m. It is responsible for 5%-10% of hospital emergency department visits. It should be differentiated from hyperthermia and hyperpyrexia. The approach must be based on orientation from symptoms and diagnostic tests, not forgetting that we are in a setting where there are tropical diseases; indeed, some divide it into malarial and non-malarial febrile syndrome.