Fever of unknown origin diagnostic criteria: Difference between revisions

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==Diagnostic Criteria==
==Diagnostic Criteria==
In 1961, Petersdorf and Beeson suggested the following criteria:<ref name="Mandell">
According Petersdorf and Beeson diagnostic criteria proposed in 1991:<ref name="pmid32462043">{{cite journal| author=Wright WF, Auwaerter PG| title=Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma. | journal=Open Forum Infect Dis | year= 2020 | volume= 7 | issue= 5 | pages= ofaa132 | pmid=32462043 | doi=10.1093/ofid/ofaa132 | pmc=7237822 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32462043  }}</ref><ref name="pmid22475734">{{cite journal| author=Hayakawa K, Ramasamy B, Chandrasekar PH| title=Fever of unknown origin:  an evidence-based review. | journal=Am J Med Sci | year= 2012 | volume= 344 | issue= 4 | pages= 307-16 | pmid=22475734 | doi=10.1097/MAJ.0b013e31824ae504 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22475734  }}</ref>
[http://www.ppidonline.com/ Mandell's Principles and Practices of Infection Diseases] 6th Edition (2004) by Gerald L. Mandell MD, MACP, John E. Bennett MD, Raphael Dolin MD, ISBN 0-443-06643-4 · Hardback · 4016 Pages Churchill Livingstone </ref><ref name="Harrison">[http://books.mcgraw-hill.com/medical/harrisons/ Harrison's Principles of Internal Medicine] 16th Edition, The McGraw-Hill Companies, ISBN 0-07-140235-7</ref>
* Fever higher than 38.3°C (100.9°F) on several occasions
* Persisting without diagnosis for at least 3 weeks
* At least 1 week's investigation in hospital


==Classification==
* Fever above 38.3° C (100.9° F)
In 1991, Durack and Street proposed a revised definition in which cases of FUO are categorized into four subclasses: classic FUO, nosocomial (health care-associated) FUO, neutropenic (immune-deficient) FUO, and HIV-related FUO.<ref>{{Cite journal| issn = 0195-3842| volume = 11| pages = 35–51| last1 = Durack| first1 = D. T.| last2 = Street| first2 = A. C.| title = Fever of unknown origin--reexamined and redefined| journal = Current Clinical Topics in Infectious Diseases| date = 1991| pmid = 1651090}}</ref>
* For more than three weeks
 
* No diagnosis after work up for at least three visits in outdoor or three days of stay in hospital
===Classic FUO===
Fever (>38.3° C or >100.9° F) for >3 weeks with no identified cause after 3 days of hospital evaluation or ≥3 outpatient visits
 
===Nosocomial (health care-associated) FUO===
Fever (>38.3° C or >100.9° F) in hospitalized patients receiving acute care and with no infection present or incubating on admission if the diagnosis remains uncertain after 3 days of appropriate evaluation
 
===Neutropenic (immune-deficient) FUO===
Fever (>38.3° C or >100.9° F) in patients with neutropenia (absolute neutrophil count ≤500 per mm<sup>3</sup>) or immunodeficiency if the diagnosis remains uncertain after 3 days of appropriate evaluation, including negative cultures after 48 hours
 
===HIV-related FUO===
Fever (>38.3° C or >100.9° F) for >3 weeks in outpatients with confirmed HIV infection or >3 days in inpatients with confirmed HIV infection if the diagnosis remains uncertain after appropriate evaluation


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Infectious disease]]
[[Category:Ailments of unknown etiology]]
[[Category:Ailments of unknown etiology]]

Latest revision as of 21:45, 23 January 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: febris continua e causa ignota; febris e causa ignota; febris E.C.I.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO

Diagnostic Criteria

According Petersdorf and Beeson diagnostic criteria proposed in 1991:[1][2]

  • Fever above 38.3° C (100.9° F)
  • For more than three weeks
  • No diagnosis after work up for at least three visits in outdoor or three days of stay in hospital

References

  1. Wright WF, Auwaerter PG (2020). "Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma". Open Forum Infect Dis. 7 (5): ofaa132. doi:10.1093/ofid/ofaa132. PMC 7237822 Check |pmc= value (help). PMID 32462043 Check |pmid= value (help).
  2. Hayakawa K, Ramasamy B, Chandrasekar PH (2012). "Fever of unknown origin: an evidence-based review". Am J Med Sci. 344 (4): 307–16. doi:10.1097/MAJ.0b013e31824ae504. PMID 22475734.