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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
PubMed
Abstract

Insights

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.

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