Fever of unknown origin in the elderly

Area of Science:

• Geriatric Medicine
• Infectious Diseases
• Internal Medicine

Background:

• Fever of undetermined origin (FUO) presents a diagnostic challenge, particularly in elderly patients.
• Prolonged pyrexia in geriatric populations requires careful evaluation to identify underlying causes.

Purpose of the Study:

• To identify and characterize the spectrum of disorders causing FUO in patients aged 65 and older.
• To discuss a diagnostic approach for managing persistently febrile geriatric patients.

Main Methods:

• Conducted an extensive literature survey.
• Reviewed hospital records of patients aged 65+ with FUO.
• Analyzed 111 identified cases.

Main Results:

• Identified a characteristic spectrum of underlying disorders in elderly patients with FUO.
• Found that potentially curable conditions (e.g., abdominal abscess, bacterial endocarditis, tuberculosis, giant-cell arteritis) account for over half of serious illnesses.
• Highlighted the importance of considering these treatable entities.

Conclusions:

• FUO in the elderly is frequently associated with serious, but often curable, underlying pathologies.
• A systematic diagnostic approach is crucial for effective management of prolonged fever in geriatric patients.
• Early identification of treatable causes can significantly improve patient outcomes.