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Fever of unknown origin in Israel
D Zamir1, I Leibovitz, I Polychuck
1Department of Internal Medicine D, Barzilai Medical Center, Ashkelon, Israel. zamir@barzi.health.gov.il
Acta Clinica Belgica
|April 8, 2004
Summary
Infectious diseases remain the primary cause of fever of unknown origin (FUO) in Israeli patients, with a notable increase in undiagnosed cases likely due to self-limiting viral infections.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Rheumatology
Background:
- Fever of unknown origin (FUO) presents a persistent diagnostic challenge for physicians.
- Recent decades have indicated shifts in the prevalence of FUO's main etiological categories: infections, malignancies, and collagen diseases.
Purpose of the Study:
- To assess if observed diagnostic patterns in FUO patients align with previous international reports.
- To investigate the current etiological distribution of FUO in a rural Israeli hospital setting.
Main Methods:
- Retrospective review of medical records from two rural Israeli hospitals.
- Inclusion criteria encompassed patients diagnosed with FUO or hospitalized for prolonged fever (≥7 days) in internal medicine departments.
- Data analysis involved two physicians reviewing 101 patient files meeting FUO criteria.
Main Results:
- Infectious diseases constituted the largest proportion of FUO cases at 54.5%.
- Malignant diseases accounted for 7.9% of cases, while collagen diseases represented a low 2%.
- A significant 32.7% of FUO cases remained undiagnosed, though patients recovered during hospitalization.
Conclusions:
- Infectious diseases are confirmed as the leading cause of FUO in the studied Israeli population.
- While infectious and malignant disease rates are comparable to other studies, the low prevalence of connective tissue diseases is unusual.
- The high rate of undiagnosed FUO suggests a potential role for self-limiting infectious (viral) diseases.