Fever of unknown origin diagnostic criteria
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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.; FUO; PUO; pyrexia of unknown origin
Diagnostic Criteria
In 1961, Petersdorf and Beeson suggested the following criteria:[1][2]
- 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
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.[3]
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 mm3) or immunodeficiency if the diagnosis remains uncertain after 3 days of appropriate evaluation, including negative cultures after 48 hours
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
- ↑ 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
- ↑ Harrison's Principles of Internal Medicine 16th Edition, The McGraw-Hill Companies, ISBN 0-07-140235-7
- ↑ Durack, D. T.; Street, A. C. (1991). "Fever of unknown origin--reexamined and redefined". Current Clinical Topics in Infectious Diseases. 11: 35–51. ISSN 0195-3842. PMID 1651090.