1/31/2024 0 Comments Fever of unknown origin![]() To meet the evolution of diagnostic capabilities, some modifications in the definition of FUO occurred through the years: in 1991, Durak and Street proposed that there be a distinction between classical FUO and three other types, namely nosocomial, neutropenic and HIV-associated FUO moreover, they reduced the duration of investigation, before defining a FUO, to at least 3 days in hospital or at least 3 outpatient visits. ![]() The main factors influencing the diagnostic categories are the income and the geographic position of the study country.įever of unknown origin (FUO) was originally defined by Petersdorf and Beeson as an illness of more than 3 weeks’ duration, with fever greater than 38.3 ☌ (101 ☏) on several occasions, the cause of which is uncertain after 1 week of in-hospital investigations. ![]() Conclusionsĭespite advances in diagnostics, FUO still remains a challenge, with ID still representing the first cause. Significant associations were found with model of study and FUO defining criteria, also. The multivariate regression analysis shows significant association between geographic area, with ID being more frequent in Asia and Europe having the higher prevalence of undiagnosed FUO. An association exists between study country income level and ID (increasing when the income decreases) and undiagnosed FUO (increasing when the income increases) even if not significant, the use of a pre-defined Minimal Diagnostic Work-up to qualify a fever as FUO seems to correlate with a lower prevalence of infections and a higher prevalence of undiagnosed FUO. ID were diagnosed in 37.8% of patients, NIID in 20.9%, and neoplasm in 11.6%, FUO were undiagnosed in 23.2%. ResultsĮighteen case-series, including 3164 patients, were included. Moreover, to explore changing over time, we compared these case-series with those published in 1995–2004. To identify factors associated with FUO diagnostic categories, we performed a systematic review of classical FUO case-series published in 2005–2015 and including patients from 2000. ![]() Factors influencing the final diagnosis of FUO are unclear. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.The differential diagnosis of Fever of Unknown Origin (FUO) is very extensive, and includes infectious diseases (ID), neoplasms and noninfectious inflammatory diseases (NIID). CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.Īccordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. Use of this site is subject to the Terms of Use. ©2023 by Children's Hospital of Philadelphia, all rights reserved.
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