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Published on: September 5, 2017
Fever of unknown origin caused by tuberculosis.
Jason J Bofinger1, David Schlossberg
1Section of Infectious Diseases, Temple University Hospital, Parkinson Pavilion, Philadelphia, PA 19140, USA.
Tuberculosis (TB) is a significant cause of fever of unknown origin. Early diagnosis and empirical antituberculous therapy are crucial for patients with undiagnosed fever, especially those with risk factors for TB.
Area of Science:
- Infectious Diseases
- Internal Medicine
- Pulmonology
Background:
- Tuberculosis (TB) is a frequent cause of fever of unknown origin (FUO).
- Identifying patients at risk for TB is essential for timely diagnosis.
- Risk factors include travel, age, dialysis, diabetes, high TB prevalence country of birth, and immunoincompetence.
Purpose of the Study:
- To review the salient risk factors, clinical clues, and diagnostic modalities for tuberculosis in patients with fever of unknown origin.
- To emphasize the importance of considering empirical antituberculous therapy when diagnosis is challenging.
Main Methods:
- Review of noninvasive and invasive diagnostic modalities for tuberculosis.
- Analysis of clinical findings, radiologic evaluation, and laboratory abnormalities associated with TB in FUO.
Main Results:
- Physical findings, radiologic data, and hematologic/endocrinologic abnormalities can suggest TB.
- Diagnosis can be elusive, necessitating a high index of suspicion.
Conclusions:
- Tuberculosis should be strongly considered in unexplained fever cases, particularly with identified risk factors.
- Therapeutic and diagnostic trials of antituberculous therapy are recommended for FUO patients when diagnosis remains uncertain.
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