Related Experiment Videos

Clinical spectrum of fever of unknown origin among Indian children

N Joshi1, K Rajeshwari, A P Dubey

  • 1Department of Pediatrics, Maulana Azad Medical College, New Delhi, India. joshineha_26@rediffmail.com

Annals of Tropical Paediatrics
|November 22, 2008
PubMed

Insights

Infections, particularly enteric fever, visceral leishmaniasis, and tuberculosis, were the main causes of fever of unknown origin (FUO) in Indian children. Thorough clinical and laboratory evaluations, including serology and bone marrow examination, are crucial for diagnosing FUO.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Medicine
  • Epidemiology

Background:

  • Fever of unknown origin (FUO) significantly contributes to childhood morbidity and mortality, especially in tropical regions.
  • Understanding the causes of FUO in diverse populations is critical for effective public health strategies.

Purpose of the Study:

  • To investigate the etiological factors and clinical outcomes of FUO in pediatric patients within India.
  • To identify common infectious and non-infectious causes of FUO in this demographic.

Main Methods:

  • A prospective, observational study was conducted over one year, enrolling children aged 3 months to 12 years meeting FUO criteria.
  • Initial diagnostic workup included complete blood count, peripheral smear, ESR, urine and blood cultures, tuberculin test, and chest X-ray.

Main Results:

  • A diagnosis was established in 88% of the 49 evaluated children.
  • Infections were the leading cause (69%), with enteric fever (14), visceral leishmaniasis (10), and tuberculosis (5) being most frequent.
  • Malignancy accounted for 12% of cases; spontaneous resolution occurred in most undiagnosed cases.

Conclusions:

  • Comprehensive clinical assessment and targeted laboratory investigations, including serology and bone marrow examination, are effective for diagnosing FUO in children.
  • Enteric fever, visceral leishmaniasis, and tuberculosis are key differential diagnoses for FUO in Indian children.
Abstract

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:
Patterns of Fever01:26

Patterns of Fever

Before understanding the types and patterns of fever, it is essential to know its phases.
Methods of reducing fever01:22

Methods of reducing fever

The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing 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.
Rocky Mountain Spotted Fever01:26

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...