Fever of unknown origin: Difference between revisions

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Latest revision as of 23:57, 19 February 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Niloofarsadaat Eshaghhosseiny, MD [2] Yarlagadda Harshitha, MD [3]

Synonyms and keywords: febris continua e causa ignota; febris e causa ignota; febris E.C.I.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Fever of unknown origin from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

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-{{Infobox_Disease |
+__NOTOC__
-  Name           = {{PAGENAME}} |
+{{Siren|Fever of unknown origin}}
-  Image          = |
+{{Fever of unknown origin}}
-  Caption        = |
+{{CMG}}{{NE}} {{YH}}
-  DiseasesDB     = |
-  ICD10          = {{ICD10|R|50||r|50}} |
-  ICD9           = {{ICD9|780.6}} |
-  ICDO           = |
-  OMIM           = |
-  MedlinePlus    = 003090 |
-  eMedicineSubj  = |
-  eMedicineTopic = |
-  MeshID         = D005335 |
-}}
-{{Search infobox}}
-{{CMG}}
-{{SK}} pyrexia of unknown origin, PUO, febris e causa ignota, febris E.C.I.
+{{SK}} febris continua e causa ignota; febris e causa ignota; febris E.C.I.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO
-==Diagnosis==
-A comprehensive and meticulous history (i.e. illness of family members, recent visit to the tropics, medication), repeated physical examination (i.e. [[skin rash]], [[eschar]], [[lymphadenopathy]], [[heart murmur]]) and a myriad of laboratory tests (serological, [[blood culture]], immunological) are the cornerstone of finding the cause.<ref name="Mandell"/><ref name="Oxford"/>
+==[[Fever of unknown origin overview|Overview]]==
+==[[Fever Of unknown Origin historical perspective|Historical Perspective]]==
+==[[Fever of unknown origin classification|Classification]]==
+==[[Fever of unknown origin pathophysiology|Pathophysiology]]==
-Other investigations may be needed. [[Ultrasound]] may show [[cholelithiasis]], [[echocardiography]] may be needed in suspected [[endocarditis]] and a [[CT scan]] may show [[infection]] or malignancy of internal organs. Another technique is Gallium-67 scanning which seems to visualize chronic infections more effectively. Invasive techniques (biopsy and laparotomy for pathological and bacteriological examination) may be required before a definite diagnosis is possible.<ref name="Mandell"/><ref name="Oxford"/>
+==[[Fever of unknown origin causes|Causes]]==
-[[Positron Emission Tomography]] using radioactively labelled [[Fluorodeoxyglucose]] (FDG) has been reported to have a [[Sensitivity (tests)|sensitivity]] of 84% and a [[Specificity (tests)| specificity]] of 86% for localizing the source of fever of unknown origin.<ref>{{cite journal | author = Meller J, Altenvoerde G, Munzel U, Jauho A, Behe M, Gratz S, Luig H, Becker W | title = Fever of unknown origin: prospective comparison of [18F]FDG imaging with a double-head coincidence camera and gallium-67 citrate SPET. | journal = Eur J Nucl Med. | volume = 27| issue = 11 | pages = 1617-25 | year = 2000 | id = PMID 11105817}}</ref>
+==[[Fever of unknown origin differential diagnosis|Differentiating Fever of unknown origin from other Diseases]]==
-Despite all this, diagnosis may only be suggested by the therapy chosen. When a patient recovers after discontinuing medication it likely was [[drug fever]], when antibiotics or antimycotics work it probably was infection. Empirical therapeutic trials should be used in those patients in which other techniques have failed.<ref name="Mandell"/>
+==[[Fever of unknown origin epidemiology and demographics|Epidemiology and Demographics]]==
-==Therapy==
+==[[Fever of unknown origin risk factors|Risk Factors]]==
-Unless the patient is acutely ill, no therapy should be started before the cause has been found. This is because non-specific therapy rarely is effective and mostly delays diagnosis. An exception is made for neutropenic patients in which delay could lead to serious complications. After blood cultures are taken this condition is aggressively treated with  broad-spectrum antibiotics. Antibiotics are adjusted according to the results of the cultures taken.<ref name="Mandell"/><ref name="Harrison"/><ref name="Oxford"/>
-HIV-infected persons with pyrexia and [[hypoxia (medical)|hypoxia]], will be started on medication for possible [[Pneumocystis pneumonia|''Pneumocystis jirovecii'' infection]]. Therapy is adjusted after a diagnosis is made.<ref name="Oxford"/>
+==[[Fever of unknown origin screening|Screening]]==
-==Prognosis==
+==[[Fever of unknown origin natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-Since there is a wide range of conditions associated with FUO, prognosis depends on the particular cause.<ref name="Mandell"/> If after 6 to 12 months no diagnosis is found, the chances diminish of ever finding a specific cause.<ref name="Oxford"/> However, under those circumstances prognosis is good.<ref name="Harrison"/>
-==References==
+==Diagnosis==
-<references/>
+[[Fever of unknown origin diagnostic study of choice|Diagnostic study of choice]] | | [[Fever of unknown origin history and symptoms|History and Symptoms]] | [[Fever of unknown origin physical examination|Physical Examination]] | [[Fever of unknown origin laboratory findings|Laboratory Findings]] | [[Fever of unknown origin electrocardiogram|Electrocardiogram]] | [[Fever of unknown origin x ray|X-Ray Findings]] | [[Fever of unknown origin echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Fever of unknown origin CT scan|CT-Scan Findings]] | [[Fever of unknown origin MRI|MRI Findings]] | [[Fever of unknown origin other imaging findings|Other Imaging Findings]] | [[Fever of unknown origin other diagnostic studies|Other Diagnostic Studies]]
-[[it:Febbre da causa ignota]]
+==Treatment==
+[[Fever of unknown origin medical therapy|Medical Therapy]] | [[Fever of unknown origin interventions|Interventions]] | [[Fever of unknown origin surgery|Surgery]] | [[Fever of unknown origin primary prevention|Primary Prevention]] | [[Fever of unknown origin secondary prevention|Secondary Prevention]] | [[Fever of unknown origin cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Fever of unknown origin future or investigational therapies|Future or Investigational Therapies]]
+==Case Studies==
+[[Fever of unknown origin case study one|Case #1]]
-[[Category:Infectious disease]]
-[[Category:Medical signs]]
-[[Category:Symptoms]]
 [[Category:Ailments of unknown etiology]]
 [[Category:Signs and symptoms]]
-{{WH}}
-{{WikiDoc Sources}}

Fever of unknown origin: Difference between revisions

Latest revision as of 23:57, 19 February 2021

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