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 ◽  
...  

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.

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 ◽  
...  

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.


2021 ◽  
Vol 96 (2) ◽  
pp. 101-109
Author(s):  
Eun Jin Kim

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.


2017 ◽  
Vol 18 ◽  
pp. 482-486 ◽  
Author(s):  
Horacio di Fonzo ◽  
Damian Contardo ◽  
Diego Carrozza ◽  
Paola Finocchietto ◽  
Adriana Rojano Crisson ◽  
...  

Author(s):  
Annie Antar

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.


Author(s):  
Mary J. Kasten

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.


2019 ◽  
Vol 12 (7) ◽  
pp. e229849 ◽  
Author(s):  
Ashraf Nabeel Mahmood ◽  
Osama Abulaban ◽  
Arshad Janjua

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.


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