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Fever of unknown origin in elderly patients
Vesna Turkulov1, Snezana Brkić, Sinisa Sević
1Infectious Disease Clinic, Clinical Centre of Vojvodina, Novi Sad, Serbia. dturkulov@yahoo.co.uk
Srpski Arhiv Za Celokupno Lekarstvo
|May 14, 2011
Summary
Fever of unknown origin (FUO) presents diagnostic challenges, especially in the elderly. Infections, malignancies, and autoimmune disorders are common causes, with higher inflammatory markers observed in older patients.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Geriatrics
Background:
- Fever of unknown origin (FUO) can stem from over 200 clinical conditions, with age-specific etiological differences.
- In elderly individuals, FUO is frequently linked to autoimmune processes, malignancies, bacterial infections, and vasculitis.
Purpose of the Study:
- To compare characteristics, laboratory findings, and diagnostic outcomes of FUO in elderly patients versus those younger than 65.
- To identify common causes and treatment strategies for FUO across different age groups.
Main Methods:
- A comparative study involving 100 patients diagnosed with FUO, divided into two groups: over 65 years (S) and under 65 years (K).
- Patients were treated at the Infectious Disease Clinic of the Clinical Centre of Vojvodina over a three-year period.
- Random sampling was used to select 50 patients for each homogenous group.
Main Results:
- Elderly patients exhibited significantly higher levels of inflammatory markers like erythrocyte sedimentation rate (ESR), fibrinogen, C-reactive protein (CRP), and leukocytes.
- Infections, particularly of the respiratory and urinary tracts, were the leading causes in both groups. Sepsis (28%) and endocarditis (10%) were noted in the elderly.
- Malignancies were more prevalent in the elderly group, while immune disorders occurred equally in both groups. A diagnosis remained elusive in 10% of the elderly and one-third of younger patients.
Conclusions:
- Fever of unknown origin remains a significant differential diagnostic challenge despite advancements in medical diagnostics.
- Age is a critical factor influencing the etiology and presentation of FUO, necessitating tailored diagnostic approaches.
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