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Fever of Unknown Origin in Children: A 14-Year, Single Institution Retrospective Review

Hwee Ying Lim1,2,3,4, Guadalupe Viegelmann1,2,3,4, Elis Yuexian Lee1

  • 1KK Women and Children's Hospital, Singapore.

Sage Open Pediatrics
|July 4, 2025
PubMed

Insights

This study analyzed pediatric fever of unknown origin (FUO), finding infections were the most common cause. Clinical signs like cough or mouth ulcers helped differentiate causes in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Medicine
  • Rheumatology

Background:

  • Fever of unknown origin (FUO) in children presents a diagnostic challenge.
  • Understanding the etiology and clinical associations of pediatric FUO is crucial for timely diagnosis and management.

Purpose of the Study:

  • To investigate the causes and clinical characteristics of pediatric FUO.
  • To identify associations between clinical findings and specific etiologies in children with FUO.

Main Methods:

  • Retrospective analysis of children under 18 years referred for FUO to a tertiary pediatric hospital.
  • Review of clinical profiles, interventions, and outcomes from December 2004 to January 2019.

Main Results:

  • Infections were the most common cause (54.0%), followed by inflammatory (17.3%), hematology/oncological (6.6%), and unknown (22.1%) causes.
  • Typhoid fever, Kikuchi-Fujimoto Disease, and hemophagocytic lymphohistiocytosis were the most frequent causes in their respective categories.
  • Specific symptoms like cough (infections), mouth ulcers/joint pain (inflammatory), and hepatosplenomegaly (hematology/oncology) were associated with different etiologies.

Conclusions:

  • This study provides valuable insights into the spectrum of pediatric FUO.
  • Clinical associations can aid in differentiating between infectious, inflammatory, and hematological/oncological causes of FUO in children.
Abstract

Keywords:
HLHchildrenfever of unknown origininfectionsinflammatory diseasemalignancy

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