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Approach to pyrexia of unknown origin in low- and middle-income countries
1Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract:
Pyrexia of unknown origin (PUO) remains a significant diagnostic challenge in low- and middle-income countries (LMICs), where infections predominate despite an increasing burden of non-infectious inflammatory diseases and malignancy. Extrapulmonary tuberculosis, lymphoma, and Still's disease are among the leading causes. This article reviews the evolving epidemiology of PUO in LMICs and proposes a structured, stepwise diagnostic approach that integrates local epidemiology, potential diagnostic clues, targeted investigations, and whole-body imaging to improve diagnostic accuracy while minimising unnecessary testing.
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