Ultrasound exploration in the work-up of unexplained fever in the immunocompromized host: preliminary observations

In immunocompromized hosts, febrile episodes have an unknown origin (FUO) in about fifty per cent of cases. In this preliminary study we evaluated the role of abdominal and pleural ultrasound (US) examination for early detection of infectious sites. US exploration was performed in a cohort of 14 consecutive FUO patients early after fever onset, at patients' bedside, by a hematologist trained in diagnostic ultrasound, and it was repeated at neutrophil recovery. US exploration showed abnormal abdominal findings in 7 and pleural effusion in 3 patients. In all cases but one the abnormality was found at the first US examination. Abdominal and pleural US exploration is a low-cost, easy to use tool for the work-up of FUO in the immunocompromized host that proved to be effective in identifying the infection site in about 50% of patients.