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Unexplained fever-analysis of 233 cases in a referral hospital
1Department of Internal Medicine, Mahatma Gandhi Insttute of Medical Sciences, Sewagram, Wardha.
Abstract:
A study was conducted to analyse the causes of fever of unknown origin (FUO) in a teaching hospital in central India. Study subjects consisted of 233 patients having FUO admitted in the medical ward. Specific causes of FUO were identified in 73.4% cases. The commonest causes (46.4%) were of infectious diseases origin foremost being enteric fever (29.6%) followed by malaria (9.0%) and tuberculous fever (5.2%). Chloroquine responsive fever accounted for 26% cases of FUO. Enteric fever were seen more commonly in younger adults less than 50 years, tuberculous fever presented usually after four weeks of onset of symptoms and more in elderly patients aged 50 years or more. Intermittent type of fever was more commonly recorded in infectious diseases. Approach to causes of FUO should be focused primarily on infectious diseases followed by other specific investigations. Empirical treatment of cases having intermittent fever with chloroquine seems justifiable even in absence of malarial parasite in peripheral blood smear.
Insights
Infectious diseases, especially enteric fever, are the primary cause of fever of unknown origin (FUO) in central India. Empirical chloroquine treatment is suggested for intermittent fevers, even without malaria confirmation.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Clinical Research
Background:
- Fever of unknown origin (FUO) presents a diagnostic challenge in clinical practice.
- Identifying etiological factors is crucial for effective patient management.
Purpose of the Study:
- To analyze the spectrum of causes for FUO in a teaching hospital in central India.
- To determine the most frequent etiologies and their clinical presentations.
Main Methods:
- Retrospective analysis of 233 patients admitted with FUO.
- Categorization of identified causes, focusing on infectious diseases.
Main Results:
- Specific causes were identified in 73.4% of patients.
- Infectious diseases accounted for 46.4%, with enteric fever (29.6%), malaria (9.0%), and tuberculous fever (5.2%) being most common.
- Chloroquine-responsive fever was noted in 26% of cases.
Conclusions:
- Infectious diseases are the predominant cause of FUO in this region.
- Diagnostic approaches should prioritize infectious etiologies.
- Empirical chloroquine treatment for intermittent fevers is a reasonable strategy.