Related Experiment Videos

Fever of unknown origin: keys to determining the etiology in older patients

Wm Alan Woolery1, Fabian R Franco

  • 1Department of family and community medicine, Mercer University School of Medicine, Macon, GA, USA.

Geriatrics
|October 29, 2004
PubMed

Insights

Fever of unknown origin (FUO) in older adults is increasingly diagnosed as noninfectious, often due to tumors or connective tissue diseases. Diagnostic evaluation must balance thoroughness with the patient's quality of life.

Area of Science:

  • Internal Medicine
  • Geriatrics
  • Infectious Diseases

Background:

  • Fever of unknown origin (FUO) diagnosis is shifting from infectious to noninfectious causes like tumors and connective tissue diseases.
  • Advancements in imaging and laboratory tests influence the diagnostic landscape of FUO.
  • Older patients with FUO often exhibit nonspecific anemia and elevated erythrocyte sedimentation rate.

Purpose of the Study:

  • To review the diagnostic approaches and considerations for fever of unknown origin (FUO) in geriatric patients.
  • To highlight the changing etiology of FUO and the importance of noninfectious causes.
  • To emphasize the need for a patient-centered approach in managing geriatric FUO.

Main Methods:

  • Review of current literature and clinical guidelines for diagnosing and managing FUO in the elderly.
  • Analysis of common presentations, diagnostic work-up, and treatment strategies.
  • Consideration of the impact of diagnostic evaluations on patient quality of life.

Main Results:

  • Noninfectious causes, particularly malignancies and autoimmune diseases, are increasingly identified as the source of FUO in older adults.
  • Key diagnostic tools include patient history, physical examination, and imaging studies.
  • While laboratory tests are often nonspecific, repeat blood cultures are essential. Anemia and elevated ESR are common findings.

Conclusions:

  • The diagnostic work-up for geriatric FUO requires careful consideration of the patient's overall health and quality of life.
  • Treatment and diagnostic evaluations should be judicious, ensuring they do not impose a greater burden than the condition itself.
  • A shift towards noninfectious etiologies necessitates updated diagnostic paradigms for FUO in the elderly.

Related Concept Videos

Types of Fever01:25

Types of Fever

Fever can be triggered by several factors, including infections, nervous system disorders, certain cancers, blood diseases like leukemia, embolism, thrombosis, heatstroke, dehydration, surgical trauma, crushing injuries, and allergic reactions.
Here are the different types of fever:
Increased Body Temperature01:25

Increased Body Temperature

A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in response to an infection or illness.
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...