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Fever of unknown origin: historical and physical clues to making the diagnosis

Jill Tolia1, Leon G Smith

  • 1Department of Infectious Diseases, St. Michael's Medical Center, 111 Central Avenue, Newark, NJ 07104, USA. sachitatolia@hotmail.com

Infectious Disease Clinics of North America
|December 7, 2007
PubMed

Insights

Diagnosing fever of unknown origin (FUO) remains challenging, with no established guidelines. This article outlines a systematic approach focusing on comprehensive patient history and physical examination to improve diagnostic success rates.

Area of Science:

  • Internal Medicine
  • Clinical Diagnostics

Background:

  • Fever of unknown origin (FUO) presents a persistent diagnostic challenge for clinicians.
  • Existing literature indicates that a definitive diagnosis is not achieved in up to 30% of FUO cases.
  • The absence of published clinical guidelines complicates the diagnostic process for FUO.

Purpose of the Study:

  • To provide a systematic diagnostic framework for fever of unknown origin.
  • To highlight the critical components of patient history and physical examination in FUO diagnosis.
  • To offer guidance for clinicians facing undiagnosed febrile illnesses.

Main Methods:

  • Review of clinical approaches to fever of unknown origin.
  • Emphasis on detailed patient history taking.
  • Systematic physical examination techniques for FUO evaluation.

Main Results:

  • A comprehensive history and physical examination are identified as the cornerstone of FUO diagnosis.
  • Key elements within history and physical examination are delineated for systematic application.
  • The proposed approach aims to enhance diagnostic yield in challenging FUO cases.

Conclusions:

  • A structured approach integrating thorough history and physical examination is essential for diagnosing fever of unknown origin.
  • Implementing these systematic methods can potentially reduce the percentage of undiagnosed FUO cases.
  • Further research may benefit from evaluating the efficacy of this systematic diagnostic strategy.

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