Fever of unknown origin in Taiwan

Area of Science:

• Infectious Diseases
• Internal Medicine
• Epidemiology

Background:

• Fever of unknown origin (FUO) presents a significant diagnostic challenge globally.
• No prospective FUO studies had been conducted in Taiwan for two decades prior to this research.
• This study addresses the need for updated epidemiological data on FUO in Taiwan.

Purpose of the Study:

• To conduct a prospective investigation of FUO cases in southern Taiwan.
• To identify the etiological spectrum and common causes of FUO in the region.
• To compare short-term survival rates between diagnosed and undiagnosed FUO patients.

Main Methods:

• A prospective study was conducted from March 2001 to May 2002.
• Patients meeting modified FUO criteria at a medical center in southern Taiwan were enrolled.
• Data analysis included etiological classification and Kaplan-Meier survival analysis.

Main Results:

• Out of 94 FUO cases, infectious diseases accounted for 57.4%, with tuberculosis being the most frequent cause.
• Other diagnoses included hematologic/neoplastic (8.5%), noninfectious inflammatory (7.4%), and miscellaneous (8.5%) conditions, with 18.1% remaining undiagnosed.
• Rarely reported infections like rickettsiosis and melioidosis were observed; three cases of hemophagocytotic syndrome were noted.

Conclusions:

• Mycobacteriosis remains the primary cause of FUO in Taiwan, necessitating its identification among FUO etiologies.
• The study reveals geographical variations in FUO causes compared to international data.
• No significant difference in short-term survival was found between patients with and without a final diagnosis.