- FUO: rule of 3s: >3 outpatient visits or 3d in hospital with unrevealing w/u, and duration >3 wks
- Always important to break this down even further as this changes your differential! classic, nosocomial, immune deficient, or HIV-associated
- Here’s a great review: http://www.ncbi.nlm.nih.gov/pubmed/22475734
- Miliary pulmonary nodules ddx:
- Miliary TB, fungal infection (disseminated cocci, histo), also sarcoid, nocardia, pneumoconiosis (silicosis), varicella pneumonia, malignancy
- Steroids in disseminated TB?
- Typically used in TB pericarditis or meningitis to prevent complications such as constrictive pericarditis, hydrocephalus, focal neurologic deficits. Consider in TB-related ARDS.
- Check out this 2010 review article if you are curious for more! http://www.ncbi.nlm.nih.gov/pubmed/20949734
- Bonus pearl: When to test for immunodeficiency:check out the slide below from a rheum grand rounds earlier this month! While testing for this particular patient is not on the list, given his young age and disseminated infection, might also consider immunodeficiency testing.