Night Sweats in the Review of Systems

Clinical Significance and Documentation

• Night sweats are categorized under the "General/Constitutional" section in the review of systems, alongside symptoms such as unexplained weight loss, fever, and changes in body habitus, as recommended by the Infectious Diseases Society of America 1, 2
• The presence of night sweats can indicate infectious processes, particularly tuberculosis and HIV-related opportunistic infections, with a moderate level of evidence 3, 4
• Night sweats can also be a symptom of malignancies, especially lymphomas and other hematologic malignancies, according to the National Comprehensive Cancer Network 4
• Myeloproliferative disorders, such as post-polycythemia vera myelofibrosis and post-essential thrombocythemia myelofibrosis, can also cause night sweats, as stated by the European Society for Medical Oncology 5, 6, 7
• Menopause is a common cause of night sweats in women of appropriate age, with a high level of evidence 4
• When documenting night sweats, it is essential to record frequency, severity, and pattern, as well as associated symptoms like weight loss, fever, and cough, as recommended by the American College of Physicians 3, 4
• The American Academy of Family Physicians suggests noting associated symptoms, particularly weight loss, fever, and lymphadenopathy, when documenting night sweats 1, 2, 4
• The presence of night sweats combined with B symptoms (fever, weight loss) significantly increases concern for serious pathology, with a high level of evidence 4, 8