History

Immunocompromised context

Host defense status

Fever details and timeline

Symptom chronology

Infection focus and symptom clusters

Localizing symptoms

Exposures and context

Exposure history

Prior care and antimicrobials

Recent healthcare encounters

Prior cultures and resistant organisms

Devices and portals of entry

Indwelling devices

Recent procedures

Alarm Features

First 5 minutes and escalation triggers

Immediate escalation criteria

High risk immunocompromised syndromes

Cannot miss syndromes

Dangerous vital sign patterns

High risk vitals

Immediate consult activation triggers

Early specialty involvement triggers

Medications

Immunosuppressants and infection risk medications

Immunosuppression profile

Antimicrobial prophylaxis and adherence

Prophylaxis

Medication interactions and contraindications

Interaction traps

Allergy history

Diet

Hydration and intake

Intake pattern

Hydration indicators

Food and water exposures

High risk exposures

Substance exposures relevant to fever mimics

Exposures

Review of Systems

Constitutional and infection symptoms

Systemic symptoms

Cardiopulmonary

Cardiopulmonary symptoms

Gastrointestinal and hepatobiliary

GI symptoms

Genitourinary

GU symptoms

Neurologic and ENT

Neuro ENT symptoms

Skin and musculoskeletal

Skin MSK symptoms

Collateral History and Family History

Collateral reliability and supports

Collateral sources

Support reliability

Family and household context

Household exposures

Family history relevant to immune risk

Risk Factors

Host factors and comorbid risks

Comorbid risks

Exposure risks

Device and procedure risks

Portals of entry

Opportunistic infection risks by immune deficit

Pattern based risks

Differential Diagnosis

Life threatening

Immediate threats

Common

High probability causes

Less common and opportunistic

Opportunistic infections and mimics

Past Medical History

Immunocompromised diagnoses and timelines

Immune compromising conditions

Prior infections and colonization

Infection history

Procedures and devices

Prior procedures

Implanted devices

Physical Exam

General and hemodynamics

Clinical appearance

Vitals pattern

Focused infection source exam

Source directed exam

Subtle and high risk findings in immunocompromised

Atypical presentations

Lab Studies

Sepsis and baseline labs

Core labs

Microbiology

Cultures

Targeted tests for immune deficit patterns

Opportunistic workup

Pitfalls and limitations

Limitations

Imaging

Scoring Systems

Risk tools for severity and disposition

MRI

MRI indications in immunocompromised fever

MRI considerations

CT

CT indications

CT cautions

Ultrasound

Ultrasound applications

Ultrasound pitfalls

Special Tests

Source control and procedural diagnostics

Procedural diagnostics

Respiratory and fungal evaluation

Advanced infectious testing

ECG

Indications in febrile immunocompromised patient

ECG triggers

High risk patterns and medication safety

Patterns impacting management

Assessment

Problem representation and severity

Syndrome framing

Key complications to rule out early

Complications

Diagnostic uncertainty tracking

Alternative explanations

Plan

Immediate stabilization priorities

Time critical actions

Antibiotics timing and selection

Antibiotic timing targets

Empiric regimens local protocol dependent

Antifungal and antiviral escalation

Antifungal escalation local protocol dependent

Antiviral considerations

Source control and consultation

Source control priorities

Consultations

Reassessment loop

Reassessment cadence

Disposition

ICU criteria

ICU indications

Inpatient admission criteria

Admission indications

Observation or outpatient pathway local protocol dependent

Lower risk candidates

Transfer criteria

Higher level care needs

Discharge Instructions

Copy discharge instructions

Diagnosis summary

Medications

Hydration and activity

Follow up timing

Return immediately for

References

Guidelines and key references

Core guidance

Project source file