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Fever of unknown origin: a survey on 133 patients
Abstract:
The hospital records of one hundred and thirty-three patients with fever of unknown origin (FUO) were studied. An etiologic diagnosis had been made in 105 patients: 41 patients had an infection, 24 had a neoplasm, 17 had a connective tissue disease, and 23 had various diseases grouped under "miscellaneous." FUO was self-limiting in 25 of the remaining patients. Invasive procedures (arteriography, biopsy, laparoscopy, paparotomy) were necessary to establish a diagnosis in 67 patients, non-invasive tests (sero-immunologic, bacteriologic, conventional radiologic tests, clinical course and treatment response) were sufficient in 27 patients. In 11 patients, the cause of FUO was determined in necropsy. Thirty patients died of FUO: 6 patients with a neoplasm, 4 with a connective tissue disease, and 7 with diseases termed miscellaneous.
Insights
Investigating fever of unknown origin (FUO) in 133 patients revealed infections, neoplasms, and connective tissue diseases as common causes. Diagnostic procedures varied, with invasive methods often required for definitive etiologic diagnosis.
Area of Science:
- Internal Medicine
- Diagnostic Medicine
Background:
- Fever of unknown origin (FUO) presents a diagnostic challenge in clinical practice.
- Understanding the etiologies and diagnostic pathways for FUO is crucial for patient management.
Purpose of the Study:
- To analyze the etiologic diagnoses and diagnostic approaches in a cohort of patients presenting with FUO.
- To identify the most frequent causes of FUO and evaluate the utility of various diagnostic procedures.
Main Methods:
- Retrospective review of hospital records for 133 patients diagnosed with FUO.
- Categorization of etiologies into infection, neoplasm, connective tissue disease, miscellaneous, and self-limiting cases.
- Assessment of diagnostic procedures, including invasive and non-invasive tests, and necropsy findings.
Main Results:
- Etiologic diagnoses were established in 105 patients: 41 infections, 24 neoplasms, 17 connective tissue diseases, and 23 miscellaneous.
- FUO was self-limiting in 25 patients.
- Invasive procedures were required for diagnosis in 67 patients, while non-invasive tests sufficed for 27.
- Necropsy determined the cause in 11 patients.
- Mortality was observed in 30 patients, with neoplasms, connective tissue diseases, and miscellaneous conditions being leading causes.
Conclusions:
- Infections, neoplasms, and connective tissue diseases are significant causes of FUO.
- A substantial proportion of FUO cases require invasive diagnostic procedures.
- Diagnostic strategies should be tailored to individual patient presentations to achieve timely etiologic determination.