Fever of unknown origin: a view from the community hospital

A prospective study was performed in a community hospital to determine the specific diseases responsible for "fever of unknown origin." Thirty-four adults with persistent unexplained fever were subjected to extensive diagnostic evaluations. Alcoholic hepatitis and recurrent pulmonary emboli were found to be frequent causes of "fever of unknown origin" in this patient population. Approximately a third of the patients had no disease identified which would have explained the persistent fever. This group of patients, for whom no diagnosis was established, shared an important characteristic: failure to lose more than two pounds/week during the hospitalization.