Patient selection: presence of fever for > 3 weeks
Medical assessment:
(1) complete history, including occupational, recreational and travel history
(2) complete and careful physical examination
Laboratory evaluation:
(1) complete blood count (CBC)
(2) peripheral blood smear reviewed by a capable physician
(3) complete metabolic panel
(4) liver function tests including LDH and serum bilirubin
(5) urinalysis with examination of the urinary sediment
(6) rheumatoid factor (RF) and antinuclear antibodies (ANA)
(7) antibody to HIV
(8) IgM antibodies to CMV and EBV
(9) blood cultures for bacteria x3
(10) urine culture for bacteria
Additional testing if risk factors present or abnormal LFTs:
(1) IgM antibodies to Q fever
(2) serologic testing for hepatitis B and C
Imaging studies:
(1) chest X-ray
Additional tests (not in original list):
(1) PPD
