scholarly journals Clinico-epidemiological profile of fever of unknown origin in an Egyptian setting: A hospital-based study (2009–2010)

2016 ◽  
Vol 10 (01) ◽  
pp. 30-42 ◽  
Author(s):  
Ahmed F Kabapy ◽  
Amira M Kotkat ◽  
Hanan Zakaria Shatat ◽  
Ekram W Abd El Wahab
Keyword(s):  
Fever Of Unknown Origin ◽  
Vascular Diseases ◽  
Unknown Origin ◽  
Fever Hospital ◽  
Collagen Vascular Diseases ◽  
Epidemiologic Profile ◽  
Diagnostic Work ◽  
Definition Of ◽  
Epidemiological Profile ◽  
Work Up

Introduction: Fever of unknown origin (FUO) is one of the most challenging diagnostic dilemmas in the field of infectious diseases and tropical medicine. Clinicians should use the frequency distribution of disorders causing FUO to guide their diagnostic approach in patients with prolonged, unexplained fevers meeting the definition of FUO. Methodology: The present study was undertaken to examine the etiologies, clinico-epidemiologic profile, and prognosis of classical FUO in patients reporting to the Alexandria Fever Hospital in Egypt. Records of 979 patients admitted to the fever hospital (from January 2009 to January 2010) and diagnosed as having FUO were examined carefully. FUO was defined as three outpatient visits or three days in the hospital without elucidation of cause of fever. Results: A total of 979 cases (57.0% males and 43.0% females), with ages ranging from 0.2 to 90 years, were investigated. The mean duration of fever before hospitalization was 31 ± 10 days. The etiology of FUO was delineated in 97% of cases, and only 3% remained undiagnosed. Diagnoses were grouped into five major categories. Infectious causes of FUO were strongly associated with better outcome (73.7% improved). Smoking, contact with animals or birds, drug addiction, and HIV seropositivity were important risk factors associated with infections. Conclusions: Infections are the most common cause of FUO, followed by collagen vascular diseases, in our region. A three-step diagnostic work-up approach is recommended to be applied in Egypt in order to improve the quality of medical service provided to FUO patients.

scholarly journals Suspected phenobarbital-induced fever in a cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691983021
Author(s):  
Dylan M Djani ◽  
William E Draper
Keyword(s):  
Fever Of Unknown Origin ◽  
Clinical Signs ◽  
Unknown Origin ◽  
Drug Induced ◽  
Fluid Analysis ◽  
Diagnostic Work ◽  
Phenobarbital Administration ◽  
Work Up ◽  
The Brain ◽  
Diagnostic Work Up

Case summary A 3-year-old spayed female domestic shorthair cat developed a fever 1 week after starting the anticonvulsant phenobarbital. A diagnostic work-up for seizures and subsequent onset of fever of unknown origin, consisting of MRI of the brain, cerebrospinal fluid analysis and infectious disease testing, was unremarkable. The cat was switched from phenobarbital onto pregabalin with complete resolution of the fever within 24 h, consistent with a drug-induced fever following phenobarbital administration. Relevance and novel information While anticonvulsant hypersensitivities have been reported and studied in veterinary medicine, phenobarbital-induced fever outside of the context of systemic clinical signs has not been documented in the veterinary scientific literature. Drug-induced fever secondary to anticonvulsants should be considered in patients that develop a fever after starting anticonvulsant therapy with an unrewarding diagnostic work-up for fever of unknown origin.

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.

Fever of unknown origin: a new definition and proposal for diagnostic work-up

2000 ◽  
Vol 11 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Elisabeth M.H.A de Kleijn ◽  
Daniël C Knockaert ◽  
Jos W.M van der Meer
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

scholarly journals Pantoprazole: An Unusual Suspect in a Patient with Fever

2021 ◽  
Author(s):  
Nuno Melo ◽  
Sílvia Policarpo ◽  
Manuela Dias ◽  
Jorge Almeida
Keyword(s):  
Acute Hepatitis ◽  
Fever Of Unknown Origin ◽  
Stress Ulcer ◽  
Unknown Origin ◽  
Stress Ulcer Prophylaxis ◽  
Drug Fever ◽  
Ulcer Prophylaxis ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Drugs can cause fever of unknown origin. Drug fever is a diagnosis of exclusion and can lead to unnecessary investigations and prolonged hospitalization. Any drug can be responsible. Here, we describe the case of a woman admitted because of acute hepatitis. Pantoprazole was started for stress ulcer prophylaxis when she was admitted to the ICU. Fever developed a few days later and an extensive diagnostic work-up was negative. Fever remitted after pantoprazole discontinuation and the diagnosis of drug fever was established.

Contribution of 18fluoro-deoxyglucose positron emission tomography to the work-up of patients with fever of unknown origin

2004 ◽  
Vol 15 (3) ◽  
pp. 151-156 ◽  
Author(s):  
Ian Buysschaert ◽  
Steven Vanderschueren ◽  
Daniël Blockmans ◽  
Luc Mortelmans ◽  
Daniël Knockaert
Keyword(s):  
Positron Emission Tomography ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Emission Tomography ◽  
Positron Emission ◽  
Work Up

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.

Revised definition of ‘fever of unknown origin’: limitations and opportunities

2005 ◽  
Vol 50 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Önder Ergönül ◽  
Ayşe Willke ◽  
Alpay Azap ◽  
Emin Tekeli
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Definition Of

scholarly journals FRI0221 GIANT CELL ARTERITIS PRESENTING AS FEVER OF UNKNOWN ORIGIN AND DELAY IN DIAGNOSIS: ANALYSIS OF TWO DIFFERENT DECADES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 694.1-694
Author(s):  
R. Talarico ◽  
C. Stagnaro ◽  
F. Ferro ◽  
A. Figliomeni ◽  
L. Carli ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Latency Period ◽  
Unknown Origin ◽  
Signs And Symptoms ◽  
Temporal Artery ◽  
Definitive Diagnosis ◽  
The Mean ◽  
18F Fdg ◽  
Work Up

Background:Giant cell arteritis (GCA) represents the most common primary vasculitis of the elderly, that usually involves large and medium sized arteries. The wide spectrum of clinical manifestations can extensively vary, from cranial symptoms, such as headache, jaw claudication or visual alterations, to constitutional symptoms, like fever, weight loss or asthenia. Fever of unknown origin (FUO) may sometimes represents the initial symptom of GCA and when it is not associated with other typical GCA features, the diagnosis can be unluckily delayed.Objectives:The primary aim of the study was to identify the prevalence of GCA patients presenting as FUO. The secondary aims were to identify the delays in the diagnosis and to compare them between the last two decades.Methods:Epidemiological and clinical data of 274 GCA patients followed in the last 20 years in our Unit were analysed. We quantified the latency period between the onset of signs and symptoms and the final diagnosis of GCA in terms of months.Results:One hundred and eighty-five patients (49 males and 136 females, mean ± SD age at the onset 71±7 years) had shown at the onset signs and symptoms suggestive of GCA (new onset headache and/or scalp pain 86%, jaw claudication 39%, vision loss 35%, abnormal temporal artery on examination 49%, dizziness 31%) while 89 patients (33 males and 56 females, mean age at the onset 69±4 years) were sent to our attention just for the onset of FUO and for an increase of erythrocyte sedimentation rate and C-reactive protein not otherwise justified. After an extensive work-up aimed at excluding any kind of infection, malignancy or hematological disorder, the patients with FUO performed a temporal artery biopsy (TAB) and/or a (18)F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). The results from histology and/or imaging allowed us to perform the diagnosis of GCA in all cases; moreover the main PET alterations reported were characterized by a (18)FDG uptake of the aortic arch and its major braches, including the carotid, subclavian, thoracic aorta and, less frequently, the abdominal aorta. Considering the different decades, the mean latency period between the onset of FUO and the diagnosis of GCA was 6±3 months in the decade from 2000 to 2010 and 3±2 months in the last decade, that was significantly higher compared with the mean latency period between the onset of signs and symptoms suggestive of GCA and the definitive diagnosis (3±1 months) in the other patients of the cohort in the first decade. Notably the latency period between the onset of signs and symptoms suggestive of GCA and the definitive diagnosis was more close (2±1 months) to the latency period of diagnosis in FUO presenting GCA in the last decade.Conclusion:Our data underline that there is a major focus on the diagnosis of GCA, even when the presentation is not typical; this is probably due to the major knowledge reached in the last decade, to an improved sensibilization regarding the different profiles of presentation and surely on the bigger use of 18F-FDG PET in the work-up of GCA patients.Acknowledgments:noneDisclosure of Interests:None declared

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