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.

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.

Clinical value of FDG-PET/CT for the diagnosis of human immunodeficiency virus-associated fever of unknown origin: a retrospective study

2009 ◽  
Vol 30 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Catherine Castaigne ◽  
Marianne Tondeur ◽  
Stéphane De Wit ◽  
Marc Hildebrand ◽  
Nathan Clumeck ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Retrospective Study ◽  
Fdg Pet ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Clinical Value ◽  
Pet Ct ◽  
Immunodeficiency Virus ◽  
Fdg Pet Ct

Mycobacterial bone marrow infections at a medical centre in Taiwan, 2001–2009

2013 ◽  
Vol 142 (7) ◽  
pp. 1524-1532 ◽  
Author(s):  
S.-H. LIN ◽  
C.-C. LAI ◽  
S.-H. HUANG ◽  
C.-C. HUNG ◽  
P.-R. HSUEH
Keyword(s):  
Bone Marrow ◽  
Human Immunodeficiency Virus ◽  
Mycobacterium Tuberculosis ◽  
Early Treatment ◽  
Fever Of Unknown Origin ◽  
Survival Rates ◽  
Unknown Origin ◽  
Medical Centre ◽  
Common Diagnosis ◽  
Immunodeficiency Virus

SUMMARYMycobacterial bone marrow (BM) infection is the most common diagnosis established by BM examinations for fever of unknown origin. In this study, clinical features and outcomes of patients who fulfilled the criteria for BM infection due to Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) at a medical centre in Taiwan from 2001 to 2009 were investigated. The BM histopathological findings were also analysed. A total of 24 patients (16 men, eight women) with mycobacterial BM infections were found. Of these, nine (38%) were positive for human immunodeficiency virus (HIV) and six (25%) had no pre-existing immunocompromised conditions. MTB isolates were obtained from 11 (46%) patients and NTM species were isolated from 10 (42%) patients, including M. avium complex (MAC, n = 7) and M. kansasii (n = 3). Patients with MTB infections were significantly older than those with NTM infections (60·5 vs. 47·7 years, P = 0·043) and were less likely to have a positive BM culture (45% vs. 100%, P = 0·012). The 90-day survival rates for MTB and NTM BM infections were 68% and 60%, respectively (P = 0·61). In addition, the presence of BM granulomas was significantly more common in patients with MTB BM infections than in those with NTM infections (82% vs. 30%, P = 0·030). In Taiwan, the importance of NTM was not inferior to MTB and besides MAC, M. kansasii might be an important pathogen in non-HIV-infected patients. The presence of BM granulomas and caseation provides valuable information regarding early treatment pending culture results.

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.

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