Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study

Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study Publisher

Erdem H¹ ; Altawfiq JA^{2, 3} ; Abid M⁴ ; Yahia WB⁵ ; Akafity G⁶ ; Ramadan ME⁷ ; Amer F⁸ ; Elkholy A⁹ ; Hakamifard A¹⁰ ; Rahimi BA¹¹ ; Dayyab F¹² ; Caskurlu H¹³ ; Khedr R¹⁴ ; Tahir M¹⁵ Show All Authors

Erdem H¹
Altawfiq JA^{2, 3}
Abid M⁴
Yahia WB⁵
Akafity G⁶
Ramadan ME⁷
Amer F⁸
Elkholy A⁹
Hakamifard A¹⁰
Rahimi BA¹¹
Dayyab F¹²
Caskurlu H¹³
Khedr R¹⁴
Tahir M¹⁵
Zambrano L¹⁶
Khan MA¹⁷
Raza A¹⁸
Elsayed NM¹⁹
Baymakova M²⁰
Yalci A¹
Cag Y¹³
Elbahr U²¹
Ikram A¹⁷

Show Affiliations

1. Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, Turkish Health Sciences University, Ankara, Turkey
2. Specialty Internal Medicine and Quality and Patient Safety Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
3. Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, United States
4. Department of Infectious Diseases, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia
5. Internal Medicine Department, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia
6. Cape Coast Teaching Hospital, Cape Coast, Ghana
7. Medical Parasitology, Faculty of Medicine, Suez University, Suez, Egypt
8. Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
9. Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
10. Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
11. Department of Infectious Diseases, Kandahar University Medical Faculty, Teaching Hospital, Kandahar, Afghanistan
12. Department of Infectious Diseases, Mohammed Bn Khalifa Bn Salman Alkhalifa Specialist Cardiac Center, Awali, Bahrain
13. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
14. Department of Pediatric Oncology, National Cancer Institute – Cairo University, Children Cancer Hospital Egypt, Cairo, 11796, Egypt
15. Department of Medicine, Federal General Hospital, Islamabad, Pakistan
16. Institute for Research in Medical Sciences and Right to Health (ICIMEDES), Scientific Research Unit (UIC), Faculty of Medical Sciences (FCM), National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras
17. National Institute of Health, Islamabad, Pakistan
18. Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
19. Medical Parasitology Department, Research Institute of Ophthalmology, Giza, Egypt
20. Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria
21. Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Al Muharraq, Bahrain

Source: Journal of Intensive Medicine Published:2024

Abstract

Background: Fever of unknown origin (FUO) in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of FUO. Methods: A multi-center study for infectious causes of FUO in lower middle-income countries (LMIC) and low-income countries (LIC) was conducted between January 1, 2018 and January 1, 2023. In total, 15 participating centers from seven different countries provided the data, which were collected through the Infectious Diseases-International Research Initiative platform. Only adult patients with confirmed infection as the cause of FUO were included in the study. The severity parameters were quick Sequential Organ Failure Assessment (qSOFA) ≥2, intensive care unit (ICU) admission, vasopressor use, and invasive mechanical ventilation (IMV). Results: A total of 160 patients with infectious FUO were included in the study. Overall, 148 (92.5%) patients had community-acquired infections and 12 (7.5%) had hospital-acquired infections. The most common infectious syndromes were tuberculosis (TB) (n=27, 16.9%), infective endocarditis (n=25, 15.6%), malaria (n=21, 13.1%), brucellosis (n=15, 9.4%), and typhoid fever (n=9, 5.6%). Plasmodium falciparum, Mycobacterium tuberculosis, Brucellae, Staphylococcus aureus, Salmonella typhi, and Rickettsiae were the leading infectious agents in this study. A total of 56 (35.0%) cases had invasive procedures for diagnosis. The mean qSOFA score was 0.76±0.94 {median (interquartile range [IQR]): 0 (0–1)}. ICU admission (n=26, 16.2%), vasopressor use (n=14, 8.8%), and IMV (n=10, 6.3%) were not rare. Overall, 38 (23.8%) patients had at least one of the severity parameters. The mortality rate was 15 (9.4%), and the mortality was attributable to the infection causing FUO in 12 (7.5%) patients. Conclusions: In LMIC and LIC, tuberculosis and cardiac infections were the most severe and the leading infections causing FUO. © 2023 The Author(s)

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Style	Citing Format
MLA	Erdem H, et al.. "Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study." Journal of Intensive Medicine, vol. 4, no. 1, 2024, pp. 94-100.
APA	Erdem H, Altawfiq JA, Abid M, Yahia WB, Akafity G, Ramadan ME, Amer F, Elkholy A, Hakamifard A, Rahimi BA, Dayyab F, Caskurlu H, Khedr R, Tahir M, Zambrano L, Khan MA, Raza A, Elsayed NM, Baymakova M, ... Ikram A (2024). Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study. Journal of Intensive Medicine, 4(1), 94-100.
Chicago	Erdem H, Altawfiq JA, Abid M, Yahia WB, Akafity G, Ramadan ME, Amer F, et al.. "Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study." Journal of Intensive Medicine 4, no. 1 (2024): 94-100.
Harvard	Erdem H et al. (2024) 'Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study', Journal of Intensive Medicine, 4(1), pp. 94-100.
Vancouver	Erdem H, Altawfiq JA, Abid M, Yahia WB, Akafity G, Ramadan ME, et al.. Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study. Journal of Intensive Medicine. 2024;4(1):94-100.
BibTex	@article{ author = {Erdem H and Altawfiq JA and Abid M and Yahia WB and Akafity G and Ramadan ME and Amer F and Elkholy A and Hakamifard A and Rahimi BA and Dayyab F and Caskurlu H and Khedr R and Tahir M and Zambrano L and Khan MA and Raza A and Elsayed NM and Baymakova M and Yalci A and Cag Y and Elbahr U and Ikram A}, title = {Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study}, journal = {Journal of Intensive Medicine}, volume = {4}, number = {1}, pages = {94-100}, year = {2024} }
RIS	TY - JOUR AU - Erdem H AU - Altawfiq JA AU - Abid M AU - Yahia WB AU - Akafity G AU - Ramadan ME AU - Amer F AU - Elkholy A AU - Hakamifard A AU - Rahimi BA AU - Dayyab F AU - Caskurlu H AU - Khedr R AU - Tahir M AU - Zambrano L AU - Khan MA AU - Raza A AU - Elsayed NM AU - Baymakova M AU - Yalci A AU - Cag Y AU - Elbahr U AU - Ikram A TI - Infectious Causes of Fever of Unknown Origin in Developing Countries: An International Id-Iri Study JO - Journal of Intensive Medicine VL - 4 IS - 1 SP - 94 EP - 100 PY - 2024 ER -

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