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[Prolonged fever: specific issues in the young adult population]
T Carmoi1, G Grateau, M Billhot
1Clinique médicale, hôpital d'instruction des armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France. t.carmoi@wanadoo.fr
La Revue De Medecine Interne
|June 12, 2010
Summary
Prolonged unexplained fever diagnosis remains challenging for internists. While causes are similar, infectious and neoplastic cases are decreasing, with inflammatory and unknown origins comprising 30-50% of prolonged fever cases.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Rheumatology
Background:
- Prolonged unexplained fever (PUF) has been studied since the 1960s, yet remains a diagnostic challenge.
- The distribution of PUF causes has shifted over time, with a notable decrease in infectious and neoplastic etiologies.
- Inflammatory disorders and fevers of unknown origin account for a significant proportion (30-50%) of PUF cases.
Purpose of the Study:
- To review the specific challenges and management of prolonged unexplained fever in young adults.
- To discuss the common etiologies of prolonged fever, including infection, inflammation, neoplasia, and other causes.
- To highlight the generally favorable prognosis of PUF when initial management is thorough.
Main Methods:
- Review of early studies and contemporary data on prolonged fever.
- Analysis of etiological distribution across different age groups.
- Discussion of management strategies and diagnostic approaches for young adults.
Main Results:
- Infectious and neoplastic causes of PUF are decreasing across all age groups.
- Inflammatory conditions and unknown causes constitute 30-50% of PUF cases.
- The prognosis for undiagnosed PUF is typically favorable, with rare instances of life-threatening diagnoses upon follow-up.
Conclusions:
- Prolonged unexplained fever requires a systematic diagnostic approach, considering infection, inflammation, neoplasia, and other causes.
- Management in young adults presents unique considerations.
- A complete and accurate initial workup is crucial for a favorable prognosis in PUF.
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