2002 – Night Sweats Revisited
Authors: C. Franco-Paredes, D. Mehrabi, J.C. Calle, R.L. Jurado
Although Febrile Night Sweats and Non-Febrile Night Sweats are relatively nonspecific symptoms that may be attributed to a wide variety of medical conditions, their presence alone can narrow the differential, and in conjunction with other symptoms they can provide a strong clue to a specific diag- nosis. When night sweats are reported by a patient, cer- tain information should be obtained to guide the differential diagnosis: medications, menopause status, reflux symptoms, weight loss, cough/sputum, HIV/ tuberculosis exposure, and exertional symptoms such as chest pain and dyspnea . In addition, if the patient is diabetic, questions pertaining to insulin dosage and regulation may be pertinent.
Finally, certain red-flag physical examination signs that should be noticed include fever, adenopathy, hy- pertension that is episodic and difficult to control, and any neurological abnormalities . Patients should also be asked to measure their temperature when ex- periencing an episode of night sweats.
The workup of a patient with night sweats should be dictated by the constellation of symptoms and relevant physical examination findings. Should the patient have FNSs, then a work-up to identify a possible infection or malignancy is completely appropriate. Likewise, a work- up for endocrine abnormalities in the patient with NFNSs may yield better results.