Fever Quiz: Can You Track Down the Trigger?

1. A 34-year-old presents with fever (38.9°C), productive cough, and focal consolidation on chest X-ray. What is the most likely diagnosis?

Community-acquired pneumonia

Acute bronchitis

Viral upper respiratory infection

Pulmonary embolism

2. Which of the following laboratory findings is most consistent with a bacterial infection?

WBC 3,500/μL with lymphocytic predominance

WBC 15,000/μL with left shift

Normal WBC with elevated monocytes

WBC 8,000/μL with normal differential

3. A patient with fever, night sweats, and weight loss lasting 3 weeks has a normal chest X-ray. What is the next best diagnostic step?

Start empiric antibiotics

Tuberculin skin test and sputum AFB smears

Abdominal ultrasound

Empiric antifungal therapy

4. Which fever pattern is most characteristic of malaria?

Continuous fever above 39°C

Quotidian (daily) spiking fever

Tertian fever (every 48 hours)

Constant low-grade fever

5. A 28-year-old with fever and severe headache has CSF with elevated protein (150 mg/dL), low glucose (25 mg/dL), and elevated WBC (800/μL, 85% neutrophils). What is the likely diagnosis?

Viral meningitis

Bacterial meningitis

Tuberculous meningitis

Fungal meningitis

6. Which organism most commonly causes fever in patients with prosthetic heart valves?

Streptococcus viridans

Staphylococcus epidermidis

Enterococcus faecalis

Streptococcus bovis

7. A patient presents with fever, abdominal pain, and diarrhea. Blood cultures grow Salmonella. What additional complication should be evaluated?

Meningitis

Aortic aneurysm

Myocarditis

Glomerulonephritis

8. A 45-year-old with fever, fatigue, and hepatosplenomegaly has atypical lymphocytes on blood smear. Which diagnosis is most likely?

Acute leukemia

Infectious mononucleosis

Lymphoma

Chronic hepatitis

9. Which fever pattern suggests an occult abscess or malignancy?

Spike fever with chills

Sustained high fever

Fever of unknown origin (>3 weeks, >38.3°C)

Brief intermittent fever

10. A patient with fever and flank pain has pyuria and positive urine culture. What is the most appropriate initial antibiotic choice?

Vancomycin

Fluoroquinolone or cephalosporin

Penicillin G

Chloramphenicol

11. True or False: Fever in a neutropenic patient requires immediate empiric broad-spectrum antibiotics regardless of culture results.

True

False

12. A patient with fever, cough, and eosinophilia has elevated IgE levels. What diagnosis should be considered?

Acute pneumonia

Parasitic infection or atopic disease

Acute leukemia

Pulmonary embolism

13. Which of the following is a non-infectious cause of prolonged fever?

Malaria

Tuberculosis

Drug fever

Acute bacterial endocarditis

14. A 52-year-old with fever and new cardiac murmur has positive blood cultures. What is the most critical next step?

Start empiric antibiotics immediately

Obtain echocardiography before antibiotics

Obtain echocardiography and start antibiotics simultaneously

Repeat blood cultures only

15. True or False: Fever in a patient on chemotherapy always indicates infection and requires hospitalization.