Constitutional Complaints#

Constitutional symptoms are systemic manifestations that don’t localize to a single organ system. They often signal underlying systemic disease—infection, malignancy, autoimmune conditions, or endocrine disorders—and require a thoughtful, systematic approach to avoid both over-testing and missed diagnoses.

Key Principles#

  • Constitutional symptoms are nonspecific — the differential is broad; history and pattern recognition guide workup
  • Red flags matter — weight loss, night sweats, and prolonged fever together raise concern for malignancy or chronic infection
  • Age and risk factors drive testing — a 25-year-old with fatigue needs different workup than a 70-year-old with the same complaint
  • Don’t anchor on one diagnosis — constitutional symptoms often have multiple contributing factors
  • Know when to wait vs. pursue — some symptoms warrant watchful waiting; others need urgent evaluation

Topics#

Fatigue#

  • Fatigue — Systematic approach to the most common complaint in primary care; distinguishing medical causes from lifestyle factors and psychiatric conditions

Fever#

  • Fever (Acute) — Evaluation of new-onset fever; when to treat empirically vs. investigate; viral vs. bacterial differentiation
  • Fever (Prolonged/FUO) — Approach to fever lasting >3 weeks without diagnosis; classic FUO workup; when to refer

Lymphadenopathy#

  • Lymphadenopathy — Localized vs. generalized; when to biopsy; red flags for malignancy

Night Sweats#

  • Night Sweats — Distinguishing benign causes from concerning etiologies; workup approach; when to worry

Cross-References#

Constitutional symptoms frequently overlap with other complaint categories:

Backward Weight Loss (Unintentional) Fatigue Forward