scholarly journals Fever of unknown origin in special groups

2019 ◽  
Vol 65 (10) ◽  
pp. 1308-1313
Author(s):  
Leonardo Fernandes e Santana ◽  
Mateus de Sousa Rodrigues ◽  
Marylice Pâmela de Araújo Silva ◽  
Rodrigo José Videres Cordeiro de Brito ◽  
Jandir Mendonça Nicacio ◽  
...  
Keyword(s):  
Physical Examination ◽  
Fever Of Unknown Origin ◽  
Inflammatory Diseases ◽  
Empirical Therapy ◽  
Unknown Origin ◽  
Clinical History ◽  
Outpatient Visits ◽  
Special Groups ◽  
The World ◽  
Detailed Clinical History

SUMMARY Fever of undetermined origin (FUO) is a challenging entity with a striking presence in hospitals around the world. It is defined as temperature ≥ 37.8 ° C on several occasions, lasting ≥ three weeks, in the absence of diagnosis after three days of hospital investigation or 3 outpatient visits. The main etiologies are infectious, neoplastic, and non-infectious inflammatory diseases. The diagnosis is based on the detailed clinical history and physical examination of these patients, in order to direct the specific complementary tests to be performed in each case. The initial diagnostic approach of the FUO patient should include non-specific complementary exams. Empirical therapy is not recommended (with few exceptions) in patients with prolonged fever, as it may disguise and delay the diagnosis and conduct to treat the specific etiology. The prognosis encompasses mortality of 12-35%, varying according to the baseline etiology.

scholarly journals Fever of unknown origin – a literature review

2019 ◽  
Vol 65 (8) ◽  
pp. 1109-1115
Author(s):  
Leonardo Fernandes e Santana ◽  
Mateus de Sousa Rodrigues ◽  
Marylice Pâmela de Araújo Silva ◽  
Rodrigo José Videres Cordeiro de Brito ◽  
Jandir Mendonça Nicacio ◽  
...  
Keyword(s):  
Literature Review ◽  
Physical Examination ◽  
Fever Of Unknown Origin ◽  
Empirical Therapy ◽  
Unknown Origin ◽  
Clinical History ◽  
Axillary Temperature ◽  
Outpatient Visits ◽  
The World ◽  
Detailed Clinical History

SUMMARY Fever of undetermined origin (FUO) is a challenging entity with a striking presence in hospitals around the world and can be associated with a myriad of differential diagnoses. It is defined as axillary temperature ≥ 37.8 ° C on several occasions, lasting ≥ three weeks, in the absence of diagnosis after three days of hospital investigation or three outpatient visits. The main etiologies are: infectious, neoplastic, and rheumatic. The diagnosis is based on the detailed clinical history and physical examination of these patients, in order to direct the specific complementary tests to be performed in each case. Empirical therapy is not recommended (with few exceptions) in patients with prolonged fever, as it may disguise and delay the diagnosis and conduct to treat the specific etiology. The prognosis encompasses mortality of 12% - 35%, varying according to the underlying etiology. In this sense, the objective of this study is to review the main topics about fever of undetermined origin, bringing historical and scientific aspects, national and international.

scholarly journals Fever of Unknown Origin: An Overview of the Diagnostic Approach

2021 ◽  
Vol 96 (2) ◽  
pp. 101-109
Author(s):  
Eun Jin Kim
Keyword(s):  
Human Immunodeficiency Virus ◽  
Physical Examination ◽  
Fever Of Unknown Origin ◽  
Inflammatory Diseases ◽  
Unknown Origin ◽  
Rational Approach ◽  
Diagnostic Challenge ◽  
Outpatient Visits ◽  
Immunodeficiency Virus ◽  
Diagnostic Approaches

Although fever of unknown origin (FUO) was first defined in 1961, it remains a diagnostic challenge. The revised 1991 definition categorized FUO into classic FUO, nosocomial FUO, neutropenic FUO, and human immunodeficiency virus-related FUO, each requiring at least three outpatient visits or 3 days of in-hospital stay. The causes of classic FUO differ greatly geographically and temporally, and are divided into infections, noninfectious inflammatory diseases, neoplasms, and miscellaneous diseases. A systematic, comprehensive and rational approach is required for appropriate diagnosis. A medical history and physical examination are very important; they may reveal diagnostic clues. Here, we review the literature on the causes and diagnostic approaches of classical FUO.

Fever of Unknown Origin

2016 ◽  
Author(s):  
Annie Antar
Keyword(s):  
Best Management Practices ◽  
Fever Of Unknown Origin ◽  
Management Practices ◽  
Unknown Origin ◽  
Clinical History ◽  
Definitive Diagnosis ◽  
Know How ◽  
Best Management ◽  
Definition Of ◽  
Immunocompetent Patients

This chapter on fever of unknown origin (FUO) begins by clarifying the definition of FUO and continues by listing and describing the major etiologies of FUO, providing guidance on clinical workup and discussing best management practices. Discussion of FUO etiologies emphasizes that most fall under a few categories—rheumatological, infectious, neoplastic, and other. Emergency management of stable, immunocompetent patients with FUO is best when focused on an appropriate diagnostic workup so that a definitive diagnosis can be established and treated with targeted therapy. Antibiotics should not be started in the emergency department for stable, immunocompetent patients with FUO unless the specific etiology is uncovered. This chapter is concise and targeted to the emergency medicine provider who needs to know how best to evaluate and manage the patient with a clinical history consistent with FUO.

Fever of Unknown Origin

2012 ◽  
pp. 237-243
Author(s):  
Mary J. Kasten
Keyword(s):  
Physical Examination ◽  
Laboratory Tests ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Definitive Diagnosis ◽  
Radiographic Testing ◽  
Common Causes ◽  
The Common ◽  
Definition Of ◽  
Comprehensive History

Classic definition of fever of unknown origin (FUO) is a fever for more than 3 weeks, a temperature of 38.3 C or higher on several occasions, and no definitive diagnosis after 1 week of hospital evaluation. Recent series have used other criteria instead of 1 week of hospital evaluation: 1 week of intensive outpatient evaluation, 3 outpatient visits, or a battery of laboratory tests. A comprehensive history should be obtained and a physical examination and basic laboratory and radiographic testing should be performed before stating that a patient has FUO. There is no clear consensus in the literature for defining the minimal diagnostic evaluation. The common causes of FUO are infection, cancer, rheumatologic or autoimmune disorders, and miscellaneous hematologic conditions. Treatment is empirical if a cause is not found.

scholarly journals Diagnostic Use of Serum Ferritin Levels to Differentiate Infectious and Noninfectious Diseases in Patients with Fever of Unknown Origin

2013 ◽  
Vol 34 (3) ◽  
pp. 211-218 ◽  
Author(s):  
Seong Eun Kim ◽  
Uh Jin Kim ◽  
Mi Ok Jang ◽  
Seung Ji Kang ◽  
Hee Chang Jang ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Serum Ferritin ◽  
Fever Of Unknown Origin ◽  
Inflammatory Diseases ◽  
Unknown Origin ◽  
University Hospital ◽  
Disease Group ◽  
Hematologic Disease ◽  
Hematologic Diseases

INTRODUCTION: In this study, we determined whether serum ferritin levels could be used to differentiate between fever of unknown origin (FUO) caused by infectious and noninfectious diseases.METHODS: FUO patients were hospitalized at Chonnam National University Hospital between January, 2005 and December, 2011. According to the final diagnoses, five causes were identified, including infectious diseases, hematologic diseases, noninfectious inflammatory diseases, miscellaneous and undiagnosed.RESULTS: Of the 77 patients, 11 were caused by infectious diseases, 13 by hematologic diseases, 20 by noninfectious inflammatory diseases, 8 by miscellaneous diseases, and 25 were undiagnosed. The median serum ferritin levels in infectious diseases was lower than those in hematologic diseases and (median (interquartile range) of 282.4 (149.0–951.8) ng/mL for the infectious disease group, 1818.2 (485.4–4789.5) ng/mL for the hematologic disease group, and 563.7 (399.6–1927.2) ng/mL for the noninfectious inflammatory disease group,p= 0.048, Kruskal–Wallis test). By comparison using the Mann–Whitney test, statistically significant differences were found only between the infectious disease and hematologic disease groups (p= 0.049) and between the infectious disease and groups (p= 0.04).CONCLUSION: An optimal cutoff value of serum ferritin levels to predict FUO caused by a noninfectious disease (hematologic diseases, noninfectious inflammatory diseases) was established as 561 ng/mL.

scholarly journals (Doctor…My child keeps falling over) unexpected MRI findings in children with history of frequent falls and dizziness: a case series

2019 ◽  
Vol 12 (7) ◽  
pp. e229849 ◽  
Author(s):  
Ashraf Nabeel Mahmood ◽  
Osama Abulaban ◽  
Arshad Janjua
Keyword(s):  
Physical Examination ◽  
Case Series ◽  
Clinical History ◽  
Brain Stem Glioma ◽  
Mri Findings ◽  
Group Management ◽  
Wide Range ◽  
Detailed Clinical History ◽  
History Of ◽  
Low Threshold

Frequent falls and dizziness are common complaints in children. These symptoms can be caused by wide range of underlying pathologies including peripheral vestibular deficits, cardiac disease, central lesions, motor skills delay and psychogenic disorders. We report three paediatric cases who presented with complaints of repeated falls and imbalance. MRI scan revealed underlying brain lesions (frontal lobe arteriovenous malformation, exophytic brain stem glioma and cerebellomedullary angle arachnoid cyst with cerebellar tonsillar ectopia). By reporting these cases, we would like to emphasise the importance of a thorough assessment of children with similar symptoms by detailed clinical history, physical examination and maintaining low threshold for investigations, including radiological imaging. Taking in consideration, the wide range of differential diagnosis, the challenge of obtaining detailed history and difficulty of performing reliable physical examination in this age group. Management of underlying disorders can be medical, surgical or just observational.

scholarly journals Multiple Intracardiac Masses as the Primary Presentation of a Systemic Inflammatory Disease: A Big Challenge (Case Report)

2021 ◽  
Author(s):  
Zahra Khalaji ◽  
Bahar Galeshi ◽  
simin almasi ◽  
Mozhgan Parsaee ◽  
Hamidreza Pouraliakbar
Keyword(s):  
Arterial Thrombosis ◽  
Fever Of Unknown Origin ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Unknown Origin ◽  
Pregnancy Morbidity ◽  
Systemic Inflammatory Disease ◽  
Intracardiac Masses ◽  
Primary Presentation ◽  
Intracardiac Thrombi

Antiphospholipid syndrome (APS) classically presents with venous or arterial thrombosis and pregnancy morbidity. Although clinical manifestations with fever of unknown origin and intracardiac masses are unusual, in a patient with prolonged fever and multiple intracardiac thrombi, systemic inflammatory diseases such as APS should be considered.

scholarly journals Perioperative intensive care in patients with brain tumours

2011 ◽  
Vol 2 (1) ◽  
pp. 53-80
Author(s):  
Mariana A. Aquafredda ◽  
Gustavo R. Piñero ◽  
Luis R. Moscote Salazar ◽  
Carolina Polo Torres ◽  
Sandra M. Castella Leones ◽  
...  
Keyword(s):  
Intensive Care ◽  
Physical Examination ◽  
Surgical Approach ◽  
Brain Tumours ◽  
Cerebral Oedema ◽  
Pulmonary Thromboembolism ◽  
Preoperative Evaluation ◽  
Clinical History ◽  
Postoperative Haemorrhage ◽  
Detailed Clinical History

The surgery of brain tumours is not free from complications, above all taking into account that today the patients operated are even older and with multiple comorbidities associated. The multidisciplinary preoperative evaluation aims at minimising the risks; nevertheless this evaluation has not yet been defined and is not based on a strong evidence. The detailed clinical history, the physical examination including functional status and the neuroimaging are the fundamental pillars.The more critical complications occur in the immediate postoperative period: cerebral oedema, postoperative haemorrhage, intracranial hypertension and convulsions; other complications, such as pulmonary thromboembolism or infections, develop lately but are not less severe. Every surgical approach has its own complications in addition to the ones common to the whole neurosurgery.

Fever of Unknown Origin: A Prospective Study

1996 ◽  
Vol 26 (4) ◽  
pp. 169-170 ◽  
Author(s):  
R Handa ◽  
S Singh ◽  
N Singh ◽  
J P Wali
Keyword(s):  
Prospective Study ◽  
Teaching Hospital ◽  
Fever Of Unknown Origin ◽  
Vascular Diseases ◽  
Unknown Origin ◽  
Collagen Vascular Diseases ◽  
Northern India ◽  
Large Teaching Hospital ◽  
The World ◽  
A Prospective Study

Fever of unknown origin (FUO) is a problem frequently faced by clinicians all over the world. One hundred and twenty-one cases of FUO presenting to a large teaching hospital in northern India were prospectively studied over a period of 2 years. Infections were the commonest cause accounting for 43.8% cases of FUO, with tuberculosis (TB) being the commonest infection encountered. Collagen vascular diseases and tumours accounted for 15.7 and 8.3% cases, respectively. No cause could be found out in a substantial number of cases (19%) even after invasive investigations. Knowledge of the current patterns of FUO is important since many patients present with potentially treatable diseases.

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