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[Fever of unknown origin in children (author's transl)]
Insights
In pediatric fever of unknown origin (FUO), infections like tuberculosis and urinary tract infections are common causes. Thorough clinical evaluation is crucial for diagnosis in hospitalized children.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Clinical Diagnostics
Background:
- Fever of unknown origin (FUO) in children presents a diagnostic challenge.
- Prolonged fever requires thorough investigation to identify underlying causes.
Purpose of the Study:
- To investigate the causes and diagnostic approaches for FUO in hospitalized children aged 0-7 years.
- To determine the effectiveness of clinical evaluation in diagnosing FUO.
Main Methods:
- Retrospective analysis of 79 children hospitalized with FUO (>2 weeks duration).
- Exclusion of patients without observed fever after one week of hospitalization.
- Evaluation of diagnostic yield within the first fortnight of admission.
Main Results:
- A definitive diagnosis was established in 63.2% of cases within two weeks.
- Infections were the most common cause (64.5%), with tuberculosis and urinary infections predominating.
- Neoplastic diseases (leukemia) and collagenosis were diagnosed in 10 and 7 children, respectively.
- The etiology remained undetermined in 7 cases.
- Mortality rate was 7.5%.
Conclusions:
- Infections are the leading cause of FUO in pediatric patients.
- Comprehensive medical history and clinical examination are paramount for diagnosis.
- An aggressive diagnostic approach guided by clinical findings is recommended for FUO in children.
Abstract:
A study has been made of 79 children from zero to seven years of age admitted to hospital with fever of unknown origin (F.U.O.) of more than two weeks duration. Children in whom fever was not clinically observed after one week of hospitalization are not included. In 50 cases (63.2%), it was possible to establish a definitive diagnosis within the first fornight of admission. The most frequent cause of fever was that of infection, found in 51 children (64.5%), tuberculosis and urinary infections predominating with ten cases each. In another ten children neoplastic disease was diagnosed (mostly leucosis), and there was colagenosis in seven cases (8.8%). In another seven children, the etiology was not established. Mortality rate was 7.5%. Clinical history and exploration were of main importance in the orientation of the diagnoses. The findings of this study suggest that in all children presenting F.U.O., apart from hospitalization of at least one week, a very thorough anamnesis and clinical exploration are most important in establishing the diagnosis, along with a more or less aggressive approach to the problem according to the findings.