Doctor for acute flu in Berlin — house call or practice?

How we manage acute flu at home

Real influenza is not the colloquial 'flu' of a common cold — it hits suddenly, with high fever up to 40 °C, marked malaise, muscle and joint pain, headache, dry cough and a degree of exhaustion that flattens you. That is exactly why a house call is the kinder option: a notdienst waiting room with other infectious patients and a wait of hours is hardly survivable in this state, and your presence does not help the others either. We come, examine lungs and airways carefully, check pulse oximetry, listen to the heart and run an influenza A/B rapid test plus — depending on season — a SARS-CoV-2 and RSV test to secure the diagnosis.

Therapy follows a clear pattern: in young, otherwise healthy adults with confirmed influenza and symptom onset more than 48 hours ago, Tamiflu (oseltamivir) rarely makes sense — its effect on the course is small. In high-risk patients (over 65, pregnant, COPD, asthma, diabetes, immunosuppression, obesity, severe heart disease) and with early onset under 48 hours, we discuss Tamiflu as a sensible option. Symptomatic therapy is always the core: antipyretics (paracetamol or ibuprofen), inhalations, generous fluids, physical rest, enough sleep. With viscous cough, mild expectorants. Antibiotics are not part of flu therapy and are used only when a bacterial superinfection (pneumonia, sinusitis, otitis) supervenes.

When flu belongs in hospital: oxygen saturation below 92 % on room air, marked dyspnoea, increasing chest pain, sudden deterioration after temporary improvement (suspected secondary pneumonia), acute confusion, persistent fever above 40 °C despite antipyretics with marked malaise, infants under 3 months, and pregnant patients with significant illness. For these pictures we arrange admission or accompany you to A&E — for acute dyspnoea with falling saturation we call 112 together.

Example: 38-year-old with flu on a Wednesday

A 38-year-old patient in Prenzlauer Berg calls on Wednesday morning — high fever to 39.8 °C since the night, brutal limb pain, dry cough. We come in the morning. Examination: saturation 96 %, clear lungs, dry red throat without exudate. Influenza A positive. Symptom onset roughly 12 hours ago, no risk factors. We discuss Tamiflu — possible at early onset but limited effect; together we decide against. Symptomatic therapy with paracetamol alternating with ibuprofen, generous fluids, bed rest. Sickness certificate for 7 days. Phone safety net: dyspnoea, falling saturation or sudden deterioration → call. Fit again after 6 days, gentle recovery a further 7 days.

What happens during a flu house call

• History including symptom onset (relevant for the Tamiflu decision) and risk factors.
• Examination: airways, lungs, heart, throat, lymph nodes, pulse oximetry, temperature.
• Rapid tests on site: influenza A/B, SARS-CoV-2 seasonally, RSV if clinically appropriate.
• Therapy plan: symptomatic always, antiviral only on indication, antibiotic only for bacterial superinfection.
• Clear counselling on course: typically 5 – 7 days fever, then 1 – 2 weeks exhaustion; take the recovery phase seriously.
• Escalation triggers defined: what to watch, when to call again, when to dial 112.
• Sickness certificate brought along — private certificates are equally valid for employers.