Physical examination maneuver

Physical Exam

Temperature

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Video coming September 2026

How to Perform

Measure body temperature with a thermometer at a standard site — oral (in the sublingual pocket with the mouth closed), tympanic, temporal, axillary, or rectal — following the device's instructions, and record the site used along with the reading. Avoid taking an oral temperature soon after hot or cold drinks.

How to Interpret

Showing 2 of 6 findings

Appendicitis

Fever (temperature greater than or equal to 38 C) in a child
Rule in
Rule out
Minimally helpful
Evidence:Strong

Pneumonia

Fever (temperature ≥38°C / 100.4°F)
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Strong

References

  • Htun TP, Sun Y, Chua HL, Pang J. Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review. Sci Rep. 2019;9(1):7600. doi:10.1038/s41598-019-44145-y. PMID: 31110214. PMC: PMC6527561. Open access. PRISMA-compliant systematic review with QUADAS-2 quality assessment. 13 included studies (n=11,144 total adult participants in primary care, outpatient, and emergency department settings). 9 included studies assessed elevated temperature as an index test; pooled at the ≥38°C threshold per Htun's Table 2 random-effects bivariate model. Reference standard for pneumonia: chest radiograph in 13 studies.
  • Primary teaching reference: Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. Chest. 1992;101(6):1644-55. doi:10.1378/chest.101.6.1644. PMID: 1303622. Modern guideline framing: Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287. PMID: 26903338. PMC: PMC4968574. Sepsis-3 qSOFA derivation/validation: Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis. JAMA. 2016;315(8):762-774. doi:10.1001/jama.2016.0288. PMID: 26903335.
  • Primary SIRS-criterion reference: Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest. 1992;101(6):1644-55. PMID: 1303622. Sepsis-3 framing: Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. PMID: 26903338. Hypothermic-sepsis prognostic literature (modern open-access reviews and cohort studies): Drewry AM, Fuller BM, Bailey TC, Hotchkiss RS. Body temperature patterns as a predictor of hospital-acquired sepsis in afebrile adult intensive care unit patients: a case-control study. Crit Care. 2013;17(5):R200. doi:10.1186/cc12894. PMID: 24028682. PMC: PMC3906745. Wiewel MA, Harmon MB, van Vught LA, et al. Risk factors, host response and outcome of hypothermic sepsis. Crit Care. 2016;20:328. doi:10.1186/s13054-016-1510-3. PMID: 27737683. PMC: PMC5064842. Tiruvoipati R, Ong K, Gangopadhyay H, et al. Hypothermia predicts mortality in critically ill elderly patients with sepsis. BMC Geriatr. 2010;10:70. PMID: 20875107. PMC: PMC2955035.
  • Modified Duke criteria primary reference: Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30(4):633-8. doi:10.1086/313753. PMID: 10770721. Most recent update: Fowler VG, Durack DT, Selton-Suty C, et al. The 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis: Updating the Modified Duke Criteria. Clin Infect Dis. 2023;77(4):518-526. doi:10.1093/cid/ciad271. PMID: 37138445. Modern AHA guideline reference: Baddour LM, Wilson WR, Bayer AS, et al. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association. Circulation. 2015;132(15):1435-86. doi:10.1161/CIR.0000000000000296. PMID: 26373316. Modern epidemiology / prevalence reference: Cahill TJ, Prendergast BD. Infective endocarditis. Lancet. 2016;387(10021):882-93. doi:10.1016/S0140-6736(15)00067-7. PMID: 26341945.
  • Primary BWPS reference: Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22(2):263-77. PMID: 8325286. Modern guideline reference: Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016;26(10):1343-1421. doi:10.1089/thy.2016.0229. PMID: 27521067. (Open access; addresses thyroid storm as Section 11.) Validation/comparison reference: Akamizu T, Satoh T, Isozaki O, et al. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. Thyroid. 2012;22(7):661-79. doi:10.1089/thy.2011.0334. PMID: 22690898. PMC: PMC3387770. (Japan Thyroid Association criteria, validated alternative to BWPS.)
  • Bundy DG, et al. Does this child have appendicitis? JAMA. 2007;298(4):438-451. PMID: 17652298.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.