How to interview a patient with fever

Fever is a sign, not a diagnosis. The interview looks for the source, the exposures and the signs of sepsis. Wear a mask and offer one to the patient if they have respiratory symptoms.

Step by step

1. Protect yourself and the patient

   Clean your hands, use a mask if there is cough, introduce yourself and get consent. [1]

2. Fever details

   When it started, highest temperature, how it was measured, pattern, chills, shaking and sweats. [2]

3. Look for the source

   Head and neck (headache, stiff neck, sore throat, ear pain), chest (cough, breathing), belly (pain, diarrhea, vomiting), urine (burning, flank pain), skin (rash, wound, redness), joints and lines or catheters. [3]

4. Exposures

   Sick contacts, travel and where, animals, insects, food, water, and recent hospital stays or procedures. [3]

5. Immune status

   Chemotherapy, steroids, HIV, no spleen, diabetes, transplant: in these patients fever is an emergency. [3]

6. Sepsis red flags

   Confusion, fast breathing, low blood pressure, cold or mottled skin, very little urine, and a rash that does not fade when pressed. [3]

7. Medications and vaccines

   Recent antibiotics, fever reducers taken (they hide the fever), and vaccination status. [3]

8. Summarize and plan

   Name the most likely source, say if sepsis signs are present and explain the next tests. [4]

Common errors

• Not asking about travel.
• Missing that fever reducers were taken before the visit.
• Not acting fast in patients with a weak immune system.

Sources

1. CDC, Guideline for Isolation Precautions (2007) and PPE sequence
2. NBOME COMLEX-USA clinical presentations
3. NCCPA PANCE Content Blueprint
4. AAMC Core Entrustable Professional Activities (Core EPAs)

Facts and steps follow NBOME COMLEX-USA clinical presentations; NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.