II. Causes

  1. Malignancy (e.g. Lymphoma or Leukemia)
  2. Rheumatologic condition (Temporal Arteritis)
  3. Infection
    1. HIV Infection
    2. Tuberculosis
    3. Infectious Mononucleosis
    4. Fungal infection (Histoplasmosis, Coccidioidomycosis)
    5. Endocarditis
    6. Lung Abscess
  4. Endocrinopathy
    1. Menopause (See Hot Flashes)
    2. Hyperthyroidism
    3. Diabetes Mellitus
    4. Diabetes Insipidus
    5. Carcinoid
    6. Pheochromocytoma
  5. Medications
    1. Acetaminophen
    2. Aspirin
    3. Antihypertensives
    4. Phenothiazines
    5. Niacin
    6. Leuprolide (Lupron)
    7. Tamoxifen
    8. Protease Inhibitors (Indinavir, Saquinavir)
    9. Monoclonal Antibody (Daclizumab, Rituximab)
    10. Antineoplastics (Interferon alfa-2a, Pegaspargase)
  6. Drugs of Abuse
    1. Alcohol Abuse
    2. Heroin
  7. Miscellaneous Causes
    1. Sleep Apnea
    2. Gastroesophageal Reflux (GERD)
    3. Anxiety
    4. Pregnancy

III. History

  1. Infectious disease exposure (HIV, Tuberculosis)
  2. Travel (Coccidioidomycosis, Malaria)
  3. Full Review of Systems for comorbid conditions
    1. Evaluate for causes below

IV. Exam: Focused on suspected causes

V. Evaluation

  1. Step 1
    1. Evaluate for causes suggested by history and exam
  2. Step 2
    1. Complete Blood Count (CBC)
    2. Chest XRay
    3. Purified Protein Derivative (PPD)
  3. Step 3
    1. HIV Test
    2. Erythrocyte Sedimentation Rate (ESR)
  4. Step 4: Gastroesophageal Reflux Empiric Mangement
    1. Proton Pump Inhibitor trial
  5. Step 5: Chart for nocturnal fever spikes
    1. Obtain Blood Cultures if positive
    2. Include atypical organisms
      1. Haemophilus
      2. Actinobacillus
      3. Cardiobacterium
      4. Eikenella
      5. Kingella
  6. Step 6
    1. Chest CT
    2. Abdominal CT
    3. Bone Marrow Biopsy
  7. Other tests to consider
    1. Follicle Stimulating Hormone (FSH)
      1. Early menopausal symptoms suspected
  8. References
    1. Vera (2003) Am Fam Physician 67(5):1019-24 [PubMed]

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Ontology: Night sweats (C0028081)

Definition (NCI) Perspiration experienced nocturnally that is unrelated to environmental temperature.
Concepts Sign or Symptom (T184)
ICD10 R61
SnomedCT 139115006, 161859009, 42984000
LNC LP75171-6, MTHU013525
Italian Sudorazione notturna
Dutch nachtelijke transpiratie, nachtelijk; zweten, zweet; nachtzweten, zweten; nacht, nachtzweet
French Transpiration nocturne, Sueurs nocturnes
German Nachtschweiss, naechtliche Perspiration, naechtliche Schweissausbrueche
Portuguese Transpiração nocturna, Suor nocturno, Suores nocturnos
Spanish Sudor nocturno, Transpiración nocturna, sudor nocturno, sudoración nocturna (hallazgo), sudoración nocturna, Sudores nocturnos
Japanese 寝汗, 夜間発汗, ネアセ, ヤカンハッカン
English sweating heavily at night, night sweats, sweating heavily at night (symptom), Night Sweating, Night Sweats, Night sweat, night sweat, nights sweats, Nocturnal perspiration, Night sweats, Night sweats (finding), nocturnal; sweating, sweat; night sweats, sweating; night, Problem;sweating;night
Czech Noční pot, Noční poty, Noční perspirace
Hungarian Nocturnalis perspiratio, Éjszakai verejtékezés, Éjszakai izzadás