Epidemiology of Causes of Fever of Unknown Origin in an Academic Center: A Five-Year Evaluation From 2009 to 2014 Publisher



Jafari S¹ ; Fatollahzadeh A¹ ; Ghiasvand F¹ ; Seifi A¹ Show Affiliations
Source: Archives of Clinical Infectious Diseases Published:2018

Abstract

Background: Fever of unknown origin (FUO) remains a clinical challenge in both emergency and infectious diseases departments. Being clinically updated on probable etiologies helps physicians to narrow their diagnostic and treatment approach. Objectives: This study aimed to assess the causes of FUO in an academic setting in the recent 5 years to update the clinicians. Methods: In a cross-sectional study, the files all patients with the primary diagnosis of FUO were extracted and evaluated. The records were assessed with regard to patients & rsquo; age, gender, days of fever before admission, time of admission and discharge, clinical course of the disease, laboratory and other para-clinical findings were documented. The patients were then classified based on the etiology of the disease and the type of test utilized for the diagnosis. Median and frequencies were used for descriptive variables; chi-square test was performed for correlation analysis. Results: From March 2009 to April 2014, 101 patients were admitted and their files were recruited for the purpose of this study. The median age of our patient population was 39. Infections (23.1%) and non-infectious inflammatory diseases (21.1%) constituted the most common known causes of fever in our patient population. Invasive tests had been documented for 41.1% while non-diagnostic in 20%. Non-invasive tests leading to final diagnoses were performed for 48.4%. There was a significant association between the type of the utilized test for diagnosis and different etiologies of FUO (P = 0.001). Conclusions: Similar to global trends, non-infectious inflammatory diseases comprised an increasing share of the causes of FUO. However, tuberculosis remains an important infectious cause that may present with FUO or simply be overlooked in primary patient visits. Updating a local database for the causes of FUO in hospitals at certain time intervals may facilitate the diagnostic approach. © 2018, Archives of Clinical Infectious Diseases.