fever

A 55-year-old female presents to the emergency department with a 24-hour history of severe right upper quadrant pain radiating to her back, associated with nausea, vomiting, and subjective fever. On examination, she is febrile (38.5°C) and has marked tenderness and guarding in the right upper quadrant. Her vital signs are otherwise stable. Blood tests reveal a white cell count of 15 x 10^9/L and C-reactive protein of 120 mg/L. Liver function tests, including bilirubin, are within normal limits. She is initiated on intravenous fluids and broad-spectrum antibiotics. Imaging is subsequently performed. Considering the patient's clinical presentation and the findings demonstrated in the provided imaging, what is the most appropriate definitive management strategy?

A 28-year-old male presents to the emergency department with severe abdominal pain, fever, and bloody diarrhea for the past 2 days. He has a known history of Crohn's disease, diagnosed 5 years ago, and has been managed with azathioprine. He admits to inconsistent adherence to his medication regimen over the past year due to feeling well. On examination, he is febrile (38.9°C), tachycardic (110 bpm), and hypotensive (90/60 mmHg). His abdomen is distended and tender to palpation, particularly in the lower quadrants, with guarding. Laboratory investigations reveal a white blood cell count of 18,000/mm³ with a left shift, hemoglobin of 10 g/dL, platelets of 450,000/mm³, albumin of 28 g/L, and C-reactive protein (CRP) of 150 mg/L. An abdominal X-ray shows dilated loops of bowel. Which of the following is the MOST appropriate next step in the management of this patient?

A 45-year-old woman presents to the ED with right upper quadrant pain, fever, and nausea for 2 days. Her vital signs are: BP 130/80 mmHg, HR 105 bpm, Temp 38.5°C, RR 18 bpm, SpO2 98% on room air. An abdominal CT scan with contrast is performed, and a slice is shown. What is the MOST appropriate next step in management?

A 10-year-old presents with a sore throat, fever, and fatigue for 2 days. Examination reveals tonsillar exudates and tender anterior cervical lymph nodes. What is the most appropriate next step in management?

A 68-year-old woman with a history of hypertension presents with a severe headache and altered mental status. Aneurysm coiling was performed. The image shows a post-operative angiogram. 6 hours later, she develops a fever of 38.5°C and worsening neurological deficits. What is the MOST likely cause?

A 25-year-old man presents to the emergency department with a 2-day history of severe headache, photophobia, and neck stiffness. He has no significant past medical history and is not on any medications. On examination, he is febrile with a temperature of 39°C, and there is a positive Brudzinski's sign. What is the most appropriate initial investigation to confirm the diagnosis?

A 62-year-old male with a history of poorly controlled diabetes presents with right upper quadrant pain, fever, and night sweats for 3 weeks. He is on immunosuppressants following a renal transplant 5 years ago. Blood cultures are pending. Imaging is performed, as shown. What is the MOST appropriate next step in management?

A 55-year-old woman presents with 2 days of worsening right upper quadrant pain radiating to her back, nausea, and subjective fever. On examination, she is tender in the RUQ. Vitals are stable. Labs show WCC 15.0, CRP 120. This image is obtained. Given the clinical context and imaging findings, what is the most appropriate definitive management strategy?

A 25-year-old gentleman presents with 3 days of rhinorrhea, fever, cough, and abdominal pain. On examination, his temperature is 39.6°C, he has reduced breath sounds, and an enlarged spleen. Which of the following causative pathogens, if identified, would require mandatory notification in Australia?

A 68-year-old woman presents to the emergency department with a 2-day history of worsening right upper quadrant abdominal pain radiating to her back, associated with fever, chills, and yellowing of her eyes. She denies prior similar episodes but reports occasional post-prandial discomfort. On examination, she is jaundiced and tender in the right upper quadrant. Vital signs are: temperature 38.5°C, heart rate 110 bpm, blood pressure 110/70 mmHg, respiratory rate 20 breaths per minute, and oxygen saturation 97% on room air. Initial laboratory investigations reveal: white blood cell count 14,000/µL, total bilirubin 6.0 mg/dL, alkaline phosphatase 450 U/L, ALT 300 U/L, and AST 250 U/L. An ERCP is performed, and the image is obtained. Following successful intervention to relieve the obstruction, the patient's symptoms begin to improve. Considering the likely underlying cause of this presentation and the findings during the procedure, what is the MOST appropriate next step in managing this patient's condition?

A 45-year-old woman presents with RUQ pain, fever, and nausea. The image shows the likely cause. What is the MOST appropriate next step in management?

A 32-year-old male with a history of Crohn's disease presents with worsening abdominal pain, diarrhea, and a low-grade fever. He reports that his symptoms have been progressively worsening over the past few months despite being on maintenance therapy with azathioprine. A CT scan of the abdomen and pelvis is performed, as shown. Based on the imaging findings, which of the following is the MOST appropriate next step in management?

A 55-year-old farmer presents with a week of fever, severe headache, and myalgia. He reports recent exposure to lambing ewes on his property. Physical examination is unremarkable except for mild hepatomegaly and normal vital signs. Considering the patient's occupation, exposure history, and clinical presentation, what is the most likely diagnosis?

A 55-year-old man with a history of renal transplant on immunosuppression presents with a 2-week history of low-grade fever, malaise, and dull right upper quadrant discomfort. Physical examination is unremarkable except for mild tenderness on deep palpation of the right upper quadrant. Blood tests show a mild leucocytosis and elevated CRP. Imaging is performed. Based on the clinical presentation and imaging findings, what is the most appropriate next diagnostic step?

A 65-year-old male presents to the emergency department with 2 days of constant right upper quadrant pain radiating to the back, associated with nausea and subjective fever. On examination, he is febrile (38.5°C) with significant tenderness and a positive Murphy's sign in the right upper quadrant. His white cell count is elevated at 15 x 10^9/L, and CRP is 120 mg/L. Liver function tests are within normal limits. Considering the clinical findings and the provided imaging, what is the most appropriate next step in the management of this patient?

A 62-year-old male presents to the emergency department complaining of left lower quadrant abdominal pain for the past three days. He describes the pain as constant and sharp, rating it an 8 out of 10. He also reports nausea, decreased appetite, and subjective fevers. His past medical history is significant for hypertension and hyperlipidemia, both well-controlled with medications. He denies any recent travel or sick contacts. On physical examination, his abdomen is tender to palpation in the left lower quadrant with guarding. Bowel sounds are present but diminished. The remainder of his examination is unremarkable. His vital signs are: Temperature 38.2°C, Heart Rate 98 bpm, Blood Pressure 140/90 mmHg, Respiratory Rate 18 breaths per minute, and Oxygen Saturation 98% on room air. Laboratory results show a white blood cell count of 14,000/µL with a neutrophilic predominance. A CT scan of the abdomen and pelvis with intravenous contrast is performed, and a representative image is shown. Assuming the patient has no allergies, what is the MOST appropriate initial management strategy?

A 78M presents with cough, fever, confusion. BP 90/60, RR 30, Temp 38.5, SpO2 90% on air. CXR shows LUL consolidation. What is the most appropriate initial management?

An 82-year-old woman from an aged care facility presents with a 2-day history of increased confusion and lethargy. Her baseline is independent living with mild cognitive impairment. She has a chronic cough but no recent change in sputum. Vital signs: T 37.8°C, HR 95 bpm, BP 110/70 mmHg, RR 22 breaths/min, SpO2 92% on room air. Chest examination reveals decreased breath sounds at the right base. Given the clinical presentation and setting, which of the following is the most appropriate initial management step while awaiting the chest X-ray result?

A 62-year-old man, post-renal transplant, presents with RUQ pain and fever. Imaging is shown. What is the MOST appropriate next step in management?

A 55-year-old farmer presents with a week of high fever, severe retro-orbital headache, and profound muscle aches. He denies cough, sore throat, or rash. On examination, temperature is 39.5°C, pulse 90, BP 120/80. Lungs are clear to auscultation. Abdomen is soft, non-tender. Initial bloods show mildly elevated transaminases. What is the most likely diagnosis?

A 68-year-old woman presents to the emergency department with right upper quadrant abdominal pain, fever, and jaundice. Her vital signs are: temperature 38.5°C, heart rate 110 bpm, blood pressure 110/70 mmHg, respiratory rate 20 breaths per minute, and oxygen saturation 97% on room air. Initial laboratory investigations reveal: white blood cell count 14,000/µL, total bilirubin 6.0 mg/dL, alkaline phosphatase 450 U/L, ALT 300 U/L, and AST 250 U/L. An ERCP is performed, and the image is obtained. Following successful intervention, what is the MOST appropriate next step in managing this patient's condition?

A 58-year-old woman with poorly controlled diabetes presents with severe RUQ pain, fever, and vomiting for 3 days. The provided CT was performed. What is the MOST appropriate initial management strategy?

A 72-year-old man with a history of cholelithiasis presents with a 2-day history of fever, jaundice, and severe right upper quadrant pain. His vital signs are stable, but laboratory tests show elevated bilirubin and alkaline phosphatase. He is undergoing urgent ERCP for management of suspected choledocholithiasis and cholangitis. Following successful cannulation and injection of contrast, the image is obtained. Considering the findings demonstrated in the image in the context of this patient's presentation, what is the most appropriate immediate next step during this procedure?

A 68-year-old male presents with a 2-day history of worsening left lower quadrant abdominal pain, fever (38.5°C), and nausea. He has a history of similar, milder pain episodes. Examination reveals left iliac fossa tenderness with guarding. Bloods show WCC 16, CRP 120. A CT scan is performed (image provided). Considering the clinical picture and the imaging findings, which of the following represents the most appropriate initial management strategy?

A 62-year-old male presents with LLQ pain and fever. The provided image was obtained. What is the most appropriate initial management?

A 28-year-old immunocompetent patient presents with a chronic cough and low-grade fever. Initial investigations, including sputum microscopy, are negative. A PET-CT scan was performed (image shown). What is the MOST appropriate next step?

A 35-year-old man presents to the clinic with a 3-month history of persistent cough, night sweats, and weight loss. He has a history of travel to Southeast Asia six months ago. On examination, he appears thin and has crackles in the upper zones of his lungs. A chest X-ray shows cavitary lesions in the right upper lobe. What is the most likely diagnosis?

A 62-year-old male presents to the emergency department with a 2-day history of right flank pain, fever, and nausea. He reports a history of recurrent urinary tract infections. On examination, he has right costovertebral angle tenderness. Urinalysis reveals pyuria and leukocyte esterase. Which of the following is the most likely underlying condition related to the organ primarily affected in the right lumbar region?

A 65-year-old presents with 2 days of left lower quadrant pain, fever (38.5°C), and nausea. On examination, there is localised tenderness in the LLQ. Vitals: BP 130/80, HR 90, RR 16, SpO2 98%. CRP is 150 mg/L, WCC 18 x 10^9/L. This image is obtained as part of the workup. Based on the clinical presentation and imaging findings, what is the most appropriate initial management step?

A 72-year-old presents with acute cholangitis (fever, jaundice, RUQ pain). LFTs show obstructive pattern. ERCP is performed for biliary decompression and stone extraction. Following successful cannulation and cholangiography, the image is obtained. Based on the findings demonstrated in the image, what is the most appropriate immediate next step during this procedure?

A 45-year-old woman presents to the ED with right upper quadrant pain, fever, and nausea for 24 hours. Her vital signs are: HR 110, BP 130/80, Temp 38.5°C. An abdominal CT scan is performed (image attached). What is the MOST appropriate next step in management?

A 55-year-old male presents to the emergency department with a 2-day history of left lower quadrant abdominal pain, associated with a low-grade fever (38.1°C) and mild nausea. He denies vomiting, diarrhoea, or rectal bleeding. On examination, he has localised tenderness in the left iliac fossa. His vital signs are stable: BP 130/80 mmHg, HR 78 bpm, RR 16/min, SpO2 98% on air. Blood tests show a white cell count of 12.5 x 10^9/L and CRP 45 mg/L. An abdominal CT scan is performed (image provided). Considering the clinical presentation and the findings on the provided image, which of the following investigations is most appropriate to recommend for this patient *after* resolution of the acute episode?

A 32-year-old male with a history of Crohn's disease presents with worsening abdominal pain, diarrhea, and a low-grade fever. He reports that his symptoms have been progressively worsening over the past few weeks despite being compliant with his prescribed mesalamine. A CT scan of the abdomen and pelvis is performed, as shown. What is the MOST appropriate next step in management?

A 68-year-old presents with a 3-day history of fever, jaundice, and severe RUQ pain radiating to the back. Vitals: T 38.5°C, BP 110/70, HR 95. LFTs show bilirubin 150, ALP 450, ALT 120. An ERCP is performed for stone extraction. The image is captured during the procedure after cannulation. Considering the findings demonstrated in the image, what is the most appropriate immediate next step in management during the current procedure?

A 28-year-old woman presents to the clinic with a 2-week history of fever, night sweats, and a non-productive cough. She has recently returned from a trip to rural Queensland. On examination, she has crackles in the right upper lung field. A chest X-ray shows a cavitary lesion in the right upper lobe. What is the most likely diagnosis?

A 10-year-old girl with a 3-day history of shortness of breath, fever, and headache has been diagnosed with pneumonia. What signs might be seen in severe pneumonia?

A 65-year-old man with a history of COPD presents with fever, productive cough, and shortness of breath for 3 days. On examination, he has crackles in the right lower lung field. A chest X-ray shows a right lower lobe consolidation. What is the most likely diagnosis?

A 45-year-old farmer presents with a 10-day history of fever, severe retro-orbital headache, and myalgia. He denies cough or dyspnoea. Physical examination is unremarkable. What is the most appropriate initial investigation?

A 28-year-old woman presents to the clinic with a 3-day history of fever, sore throat, and difficulty swallowing. She has no significant past medical history and is not on any medications. On examination, she has swollen, tender anterior cervical lymph nodes and erythematous tonsils with white exudates. A rapid antigen detection test for group A Streptococcus is positive. What is the most appropriate treatment for her condition?

A 62-year-old woman presents with right upper quadrant pain, fever, and leukocytosis. An abdominal CT scan is performed, as shown. She has a history of similar episodes that resolved spontaneously. What is the MOST appropriate next step in management?

A 10-year-old presents with a sore throat, fever, and tonsillar exudates. Rapid strep test is negative. What is the MOST appropriate next step?

A 45-year-old woman presents to the ED with right upper quadrant pain, fever, and nausea for 24 hours. Her vital signs are: HR 110, BP 130/80, Temp 38.5°C. An abdominal CT scan is performed (image attached). What is the MOST appropriate next step in management?

A 28-year-old male with Crohn's disease presents with increased abdominal pain, fever, and bloody stools. He is on azathioprine. What is the most appropriate next step?

A 68-year-old male presents to the ED with left lower quadrant abdominal pain, fever, and leukocytosis. A CT scan of the abdomen and pelvis is performed. Based on the image, what is the MOST appropriate next step in management?

A 55-year-old male presents with LLQ pain, fever, and increased WBC. A CT scan is performed. He is hemodynamically stable. Based on the image, which of the following is the MOST appropriate initial management strategy?

A 68-year-old woman presents to the emergency department with a 2-day history of right upper quadrant abdominal pain, fever, and yellowing of her eyes. Her vital signs are stable, but laboratory investigations reveal elevated inflammatory markers and liver function tests consistent with biliary obstruction and infection. An ERCP is performed, and the image is obtained. Following successful intervention to relieve the obstruction, the patient's symptoms begin to improve. Considering the likely underlying cause of this presentation and the findings during the procedure, what is the MOST appropriate next step in managing this patient's condition?

A 35-year-old man presents to the clinic with a 3-month history of fatigue, weight loss, and night sweats. He also reports a persistent cough that has recently become productive of blood-streaked sputum. He has no significant past medical history and is not on any medications. He recently returned from a trip to Southeast Asia. On examination, he is febrile and has bilateral crackles in the upper lung fields. A chest X-ray shows cavitary lesions in the upper lobes. What is the most likely diagnosis?

A 68-year-old male presents to the ED with left lower quadrant abdominal pain, fever, and leukocytosis. A CT scan of the abdomen and pelvis is performed. Based on the imaging, what is the MOST appropriate next step in management?

A 68-year-old man presents with 3 days of worsening left lower quadrant pain, fever, and nausea. He has a history of diverticulosis. On examination, he is tachycardic (HR 105), afebrile (37.5°C), and has localised tenderness with guarding in the left iliac fossa. His blood tests show a WCC of 16 x 10^9/L and CRP 150 mg/L. He is commenced on intravenous antibiotics. A CT scan is performed (image provided). Considering the clinical context and the findings on the image, what is the most appropriate next step in management?

A 25-year-old woman presents to the clinic with a 2-week history of fatigue, sore throat, and swollen glands. She also reports a low-grade fever and mild headache. On examination, she has cervical lymphadenopathy and mild splenomegaly. A monospot test is positive. What is the most appropriate advice regarding her physical activity?