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Vojnosanitetski pregled
2016, vol. 73, iss. 1, pp. 21-25
article language: English
document type: Original Scientific Paper
published on: 03/02/2016
doi: 10.2298/VSP140820128P
Creative Commons License 4.0
Fever of unknown origin: Most frequent causes in adults patients
Clinical Centre Kragujevac, Clinic for Infectious Diseases

e-mail: biljanapop@yahoo.com

Abstract

Background/Aim. The differential diagnosis of fever of unknown origin (FUO) includes more than 200 different diseases and conditions. The aim of this study was to identify the most frequent causes of FUO among adult patients according to gender and age. Methods. The study included 74 patients examined from June 2010 to June 2013 at the Infectious Disease Clinic, Clinical Center Kragujevac in Serbia, according to the defined criteria for FUO. The patients were divided according to the diagnosis into four groups: infectious, malignant, rheumatic and 'other diseases'. A cause of febricity could not be estabilshed in a portion of subjects, and they comprised the group of undiagnosed cases. Results. Infectious diseases were dominant in the study, followed by rheumatic diseases, which were most frequently found in women and the elderly. The diseases recognised as the most common causes of febricity were subacute thyroiditis, subacute endocarditis, Still's disease, rheumatic polymyalgia with or without temporal arteritis, and cytomegalovirus infection. In 44% of the patients, the final diagnosis was composed of only six clinical entities. Conclusion. The importance of establishing the diagnosis of rheumatic disease is especially emphasised, in line with other authors' research indicating the number of these diseases is on the rise. The diagnostic approach to FUO should always be directed to the known frequency of diseases.

Keywords

References

Bleeker-Rovers, C.P., Vos, F.J., de Kleijn, E.M.H.A., Mudde, A.H., Dofferhoff, T.S.M., Richter, C., Smilde, T.J., Krabbe, P.F.M., Oyen, W.J.G., van der Meer, J.W.M. (2007) A Prospective Multicenter Study on Fever of Unknown Origin. Medicine, 86(1): 26-38
Chan-Tack, K.M., Cunha, B.A., Bartlett, J., Sanders, C.V., Talavera, F. (2011) Fever unknown origin. Medscape, from WebMD [serial on the Internet]. Available from: http://emedicine.medscape.com/article/217675-overview [cited 2012 July 8]
Cunha, B.A., Thermidor, M., Mohan, S., Valsamis, A.S., Johnson, D.H. (2005) Fever of unknown origin: Subacute thyroiditis versus typhoid fever. Heart & Lung: The Journal of Acute and Critical Care, 34(2): 147-151
Cunha, B.A. (2007) Fever of Unknown Origin: Focused Diagnostic Approach Based on Clinical Clues from the History, Physical Examination, and Laboratory Tests. Infectious Disease Clinics of North America, 21(4): 1137-1187
Cunha, B.A. (2004) Fever of unknown origin caused by adult juvenile rheumatoid arthritis: The diagnostic significance of double quotidian fevers and elevated serum ferritin levels. Heart & Lung: The Journal of Acute and Critical Care, 33(6): 417-421
Durack, D.T., Street, A.C. (1991) Fever of unknown origin-reexamined and redefined. Curr Clin Top Infect Dis, 11: 35-51
Ergönül, Ö., Willke, A., Azap, A., Tekeli, E. (2005) Revised definition of ‘fever of unknown origin’: limitations and opportunities. Journal of Infection, 50(1): 1-5
Finch, R.G., Davies, G.R., Civljak, R. (2006) Fever of unknown origin. in: Begovac J., Borovic D., Lisic M. [ed.] Infectology, Zagreb: Profil International, 1st ed, p. 123-7. (Croatian)
Gaeta, G.B., Fusco, F.M., Nardiello, S. (2006) Fever of unknown origin: a systematic review of the literature for 1995???2004. Nuclear Medicine Communications, 27(3): 205-211
Gleckman, R.A., Esposito, A.L. (1984) Fever of unknown origin in older patients. Geriatrics, 39, str. 46-51
Horowitz, H.W. (2013) Fever of Unknown Origin or Fever of Too Many Origins?. New England Journal of Medicine, 368(3): 197-199
Knockaert, D.C., Vanderschueren, S., Blockmans, D. (2003) Fever of unknown origin in adults: 40 years on. Journal of Internal Medicine, 253(3): 263-275
Kucukardali, Y., Oncul, O., Cavuslu, S., Danaci, M., Calangu, S., Erdem, H., Topcu, A.W., Adibelli, Z., Akova, M., Karaali, E.A. (2008) The spectrum of diseases causing fever of unknown origin in Turkey: a multicenter study. International Journal of Infectious Diseases, 12(1): 71-79
Petersdorf, R.G., Beeson, P.B. (1961) Fever of unexplained origin: report on 100 cases. Medicine, 40: 1-30
Tal, S., Guller, V., Gurevich, A., Levi, S. (2002) Fever of unknown origin in the elderly. Journal of internal medicine, 252(4): 295-304
Turkulov, V., Brkić, S., Sević, S., Marić, D., Tomić, S. (2011) Fever of unknown origin in elderly patients. Srpski arhiv za celokupno lekarstvo, vol. 139, br. 1-2, str. 64-68
Uppal, S.S., Al-Mutairi, M., Hayat, S., Abraham, M., Malaviya, A. (2007) Ten years of clinical experience with adult onset Still's disease: is the outcome improving?. Clinical rheumatology, 26(7): 1055-60
Zenone, T. (2006) Fever of unknown origin in adults: Evaluation of 144 cases in non-university hospital. Scand J Infect Dis, 38:632