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Undiagnosed undifferentiated fever in Far North Queensland, Australia: a retrospective study
Tri Nugraha Susilawati1, William John Hannan McBride1
1School of Medicine and Dentistry, Faculty of Medicine, Health and Molecular Sciences, James Cook University, Queensland, Australia.
Objectives:
This study aimed to describe the causes of acute undifferentiated fever (AUF) and to develop a robust definition of undiagnosed undifferentiated fever (UUDF).
Methods:
This was a retrospective study of AUF over 3 years (2008-2011) in an Australian tertiary hospital. Request for laboratory investigation of one or more infectious agents was used as the search tool.
Results:
A total of 340 patients with AUF, aged 15-65 years, were identified over the study period. A final diagnosis was made in 147 (43.2%) patients, dengue fever being the most frequent. The aetiology of fever was not determined in 193 (56.8%) patients. Elevations of C-reactive protein (CRP) and hepatic aminotransferase levels were common in these patients; two patients died. The characteristics of UUDF were fever for ≤21 days and failure to reach a diagnosis after clinical evaluation and specific laboratory investigations.
Conclusion:
The high burden of UUDF argues for a better diagnostic approach to fever that is capable of identifying a broad range of infectious agents.
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