scholarly journals Prevalence of Connective Tissue Diseases in Egyptian Patients Presenting with Fever of Unknown Origin

2011 ◽  
Vol 4 ◽  
pp. CMAMD.S6763 ◽  
Author(s):  
Mohamad S. Abdelbaky ◽  
Howaida E. Mansour ◽  
Shafika I. Ibrahim ◽  
Iman A. Hassan
Keyword(s):  
Connective Tissue ◽  
Fever Of Unknown Origin ◽  
Urine Analysis ◽  
Complete Blood Count ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Medical Problem ◽  
Advanced Technology ◽  
Diagnostic Tools ◽  
History Taking

Objective To estimate the prevalence of connective tissue diseases in patients presenting with fever of unknown origin (FUO). Patients and Methods In this study thirty patients diagnosed as FUO (Group 1), in 2008, were included in an observational study and diagnostic workup. Additionally, retrospective analysis of seventy patients’ files (Group 2), for patients who presented with prolonged unexplained pyrexia to the same hospital in the previous two years, was performed. Patients were subjected to: full clinical assessment including full history taking, thorough clinical examination, laboratory investigations including the basic investigations for patients with prolonged fever, complete blood count, erythrocytes sedimentation rate, urine analysis and culture, blood culture, sputum culture and plain chest X ray. Further diagnostic work up and/or procedures were requested according to the potential diagnostic clues (PDC) present in every patient. Results Out of 100 FUO patients, 50% were found to have infectious diseases, 24% were found to have connective tissue diseases, 8% miscellaneous causes and 7% neoplastic diseases ( P < 0.05). In 11 patients no definite cause for FUO could be identified. Connective tissue patients were: eight systemic lupus patients (33.3%), five patients with familial mediterranean fever (20.8%), four patients with rheumatoid arthritis (16.6%), three patients (12.5%) with Still's disease and Rheumatic fever and one patient with Behçet syndrome/Crohn's disease (4.3%), ( P < 0.05). Conclusions Despite the advanced technology, FUO remains a challenging medical problem. Infections were the most common cause of FUO in Egypt, confirming the trends found in other parts of the world. There was an increased prevalence of connective tissue patients presented with prolonged unexplained fever. A keen clinical eye, meticulous history taking and repeated physical examination remained the most important diagnostic tools in FUO patients.

scholarly journals Fever of unknown origin as the major manifestation of subacute thyroiditis

2021 ◽  
Vol 2021 ◽  
Author(s):  
Ahmad Housin ◽  
Marc P Pusztaszeri ◽  
Michael Tamilia
Keyword(s):  
Fever Of Unknown Origin ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Signs And Symptoms ◽  
Medical Problem ◽  
Subacute Thyroiditis ◽  
Endocrine Disorders ◽  
List Type ◽  
Thyroid Function Tests ◽  
Markers Of Inflammation

Summary Fever of unknown origin is a commonly encountered medical problem. Most common causes include infections, malignancy, and connective tissue diseases. Endocrine causes are rare but are well documented. While fever is common in some endocrine disorders, fever of unknown origin as the sole presenting feature is very rare. We describe a case report of a 63-year-old male who presents with fever of unknown origin. Imaging and biopsy results confirmed the diagnosis of subacute thyroiditis. He was started on prednisone with a good response. We conclude that subacute thyroiditis should be considered in the work up of fever of unknown origin even in the absence of classical signs and symptoms. Learning points Fever of unknown origin is a rare sole presentation of subacute thyroiditis. The classic signs and symptoms may not be manifest at the time of presentation. Normal thyroid function tests and elevated markers of inflammation often make infections, malignancy and autoinflammatory conditions the prime consideration. Imaging of the thyroid gland may point to a morphologic aberration and prompt a thyroid biopsy. After exclusion of infection, a rapid response to steroids may be both diagnostic and therapeutic.

scholarly journals Fever in the tropics: aetiology and clinical profile of fever of unknown origin in children-a prospective observational study in a tertiary care hospital in South India

2019 ◽  
Vol 6 (5) ◽  
pp. 1834
Author(s):  
Ramachandran Sumathisri ◽  
Karuppiah Pandi ◽  
Sadagopan Srinivasan
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Fever Of Unknown Origin ◽  
Urine Analysis ◽  
Complete Blood Count ◽  
Tertiary Care ◽  
Unknown Origin ◽  
Tuberculin Test ◽  
Care Hospital ◽  
Indian Children

Background: Fever of unknown origin (FUO) is an important cause of morbidity and mortality in children, especially in tropical countries with varied aetiology and clinical presentation. Aim of this study is to determine the aetiology and outcome of FUO in Indian children. Study design is Prospective, observational study.  Methods: We enrolled 75 children aged 1 to 12 years who were admitted with fever >8 days to the paediatric department from January 2015 to August 2016. Initial evaluation included complete blood count, peripheral smear, urine analysis, chest radiography, blood culture and tuberculin test.  Results: In 72 children (96%), a definitive diagnosis could be established, whereas 3 children (4%) remained undiagnosed. Most common aetiology of FUO was infectious disease (90.6%) followed by malignancy (4%) and collagen vascular disease (1.3%). Among the infections group, scrub typhus was found to be the commonest aetiology (52%).Conclusions: Infections were the most common etiological factor for FUO in children aged 1-12 years of our region.

scholarly journals ETIOLOGY AND CLINICAL PROFILE OF FEVER OF UNKNOWN ORIGIN IN CHILDREN-A PROSPECTIVE OBSERVATIONAL STUDY IN PEDIATRICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-3
Author(s):  
Raman Paswan ◽  
Ashok KUMAR ◽  
Debarshi Jana
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Fever Of Unknown Origin ◽  
Urine Analysis ◽  
Complete Blood Count ◽  
Unknown Origin ◽  
Tuberculin Test ◽  
Test Results ◽  
Indian Children ◽  
Peripheral Smear

Background: Fever of unknown origin (FUO) is an important cause of morbidity and mortality in children, especially in tropical countries with varied aetiology and clinical presentation. Aim of this study is to determine the aetiology and outcome of FUO in Indian children. Study design is Prospective, observational study. Methods: We enrolled 75 children aged 1 to 12 years who were admitted with fever >8 days to the pediatric department of DMCH, Laheriasarai, Bihar from November 2019 to June 2020. Initial evaluation included complete blood count, peripheral smear, urine analysis, chest radiography, blood culture and tuberculin test. Results: In 72 children (96%), a definitive diagnosis could be established, whereas 3 children (4%) remained undiagnosed. Most common aetiology of FUO was infectious disease (90.6%) followed by malignancy (4%) and collagen vascular disease (1.3%). Among the infections group, scrub typhus was found to be the commonest aetiology (52%). Conclusions: Infections were the most common etiological factor for FUO in children aged 1-12 years of our region.

Fever of unknown origin in the elderly: nine years experience in China

2008 ◽  
Vol 38 (4) ◽  
pp. 221-222 ◽  
Author(s):  
Minghua Zheng ◽  
Hailong Lin ◽  
Sheng Luo ◽  
Lihua Xu ◽  
Yanjun Zeng ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Older Patients ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
The Elderly ◽  
Medical College ◽  
Frequent Type ◽  
Wenzhou Medical College

This is a retrospective study of older patients admitted to the First and Second Affiliated Hospitals of Wenzhou Medical College, China, with a diagnosis of fever of unknown origin. The study took place from January 1998 to December 2006 among 102 patients who fulfilled the criteria. Infections were responsible for 50 cases (49.1%), followed by no diagnosis in 27 (26.5%), miscellaneous in nine (8.8%), neoplasms in eight (7.8%) and connective tissue disease in another eight (7.8%). Mycobacterium TB was the most frequent type of infection diagnosed.

scholarly journals Etiology of fever of unknown origin in children.

2021 ◽  
Vol 28 (04) ◽  
pp. 552-556
Author(s):  
Aysha Mansoor Lodhi ◽  
Wajiha Rizwan ◽  
Mubeen Nazar ◽  
Asma Mushtaq ◽  
Muhammad Sahir Saud ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Fever Of Unknown Origin ◽  
Lymphoblastic Leukemia ◽  
Unknown Origin ◽  
Connective Tissue Disorder ◽  
Definitive Diagnosis ◽  
Female Ratio ◽  
Qualitative Variables ◽  
Age Range

Objectives: To determine the etiology of Fever of Unknown Origin (FUO) in children. Study Design: Prospective Observational study. Setting: Department of Pediatric Medicine, The Children's Hospital, Lahore. Period: August 2019 to January 2020. Material & Methods: A total of 45 children aged between 01 to 180 months (15 years), having FUO were included. FUO was defined as a temperature of greater than 100.4ºF documented by a health care provider, persisting over a period of three weeks and for which no cause could be identified after at least 8 days of evaluation. All the study information was analyzed by using standard software SPSS 20. The quantitative variables like age and duration of fever before hospital admission were presented as mean and standard deviation. Qualitative variables like sex, antibiotic therapy use before definitive diagnosis and various diagnoses made were presented as frequencies and percentages. Results: The patient’s age range was from 01 to 180 months with mean of 80±45.12 months and male to female ratio was 2.2:1. Definitive diagnosis was made in 37(82.2%) patients. Infections were the predominant cause of FUO (44.4%) followed by malignancy (24.4%). Tuberculosis was the most common infection while Acute Lymphoblastic leukemia dominated the malignancy. Systemic lupus erythematosus was the most commonly diagnosed connective tissue disorder.  There was a significant association between duration of fever and the ultimate diagnosis (p=0.01). Conclusion: Infectious diseases were the most common cause of FUO followed by malignancy, connective tissue disorders and miscellaneous causes.

scholarly journals A study of etiology of fever of unknown origin in children aged 2 months to 18 years

2021 ◽  
Vol 8 (11) ◽  
pp. 1842
Author(s):  
Naveen Gandla ◽  
Sheela A. Bharani ◽  
Tushar P. Shah
Keyword(s):  
Enteric Fever ◽  
Fever Of Unknown Origin ◽  
Lymphoblastic Leukemia ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Age Group ◽  
Antimicrobial Drugs ◽  
Cross Sectional ◽  
Female Ratio ◽  
Geographical Regions

Background: In an era of advance science of modern technologies, many diseases are diagnosed and excluded rapidly and now Fever of Unknown Origin (FUO) has been redefined for any fever of 380C lasting for more than 7 days without any clear cause. The aetiology varies according to different geographical regions, socioeconomical status, age, prevalence of resistance to antimicrobial drugs and genetic susceptibility.Methods: It was a descriptive cross sectional, hospital-based study, carried out on 150 children from August 2018 to May 2020. All cases in the age group of 2 months to 18 years with fever of >38.0°C, lasting for more than 7 days without a clear source were included.Results: The mean age of presentation was 5.8 years±Standard Deviation of 3.7 years with male to female ratio was 1.4:1. Nearly half of the cases, presented with the duration of fever between 8-14 days. Enteric fever in 52%, tuberculosis in 13.3% and acute lymphoblastic leukemia (ALL) in 8.5% were three common etiologies found in this study. Amongst all cases of FUO, infective causes were seen in 113 (75.3%) followed by malignancies in 15(10%) cases. In 10 (6.7%) cases, cause could not be established.Conclusions: Enteric fever and tuberculosis were the leading etiologies from infective subgroup of FUO. ALL was the commonest cause from malignancies sub group. FUO presenting with low haemoglobin, platelet is a pointer towards malignancy. Occurrence of FUO with infectious diseases and malignancies was found in younger age group as compared to connective tissue diseases. 

Connective tissue diseases in later life

1998 ◽  
Vol 8 (3) ◽  
pp. 189-196
Author(s):  
JE Brockbank ◽  
ML Snaith
Keyword(s):  
Side Effects ◽  
Connective Tissue ◽  
Elderly Patients ◽  
Older Patients ◽  
Significant Proportion ◽  
Connective Tissue Diseases ◽  
Unknown Origin ◽  
Later Life ◽  
Pyrexia Of Unknown Origin ◽  
System Disorder

The connective tissue diseases and vasculitides are primarily conditions of the early and middle years. However, a significant proportion of patients do present in later life, and some conditions, such as giant cell arteritis, are almost exclusively confined to older patients. In later years, their presentation may differ from the classical descriptions and require a broader diagnostic sieve. Thirty per cent of elderly patients with pyrexia of unknown origin have a multi-system disorder. Autoantibody tests throw up more false positives with the risk of over-diagnosis and treatment is further complicated by the burden of co-existent disease and morbidity from therapeutic side-effects.

Progress Report: Next-Generation Sequencing (NGS), Multiplex Polymerase Chain Reaction (PCR), and Broad-Range Molecular Assays as Diagnostic Tools for Fever of Unknown Origin (FUO) Investigations in Adults

2021 ◽  
Author(s):  
William F Wright ◽  
Patricia J Simner ◽  
Karen C Carroll ◽  
Paul G Auwaerter
Keyword(s):  
Next Generation Sequencing ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Diagnostic Tools ◽  
Rrna Gene ◽  
Next Generation ◽  
Potential Cost ◽  
Microbial Identification ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Abstract Even well into the 21st century, infectious diseases still account for most causes of fever of unknown origin (FUO). Advances in molecular technologies, including broad-range PCR of the 16S rRNA gene followed by Sanger sequencing, multiplex PCR assays, and more recently, next-generation sequencing (NGS) applications, have transitioned from research methods to more commonplace in some clinical microbiology laboratories. They have the potential to supplant traditional microbial identification methods and antimicrobial susceptibility testing. Despite the remaining challenges with these technologies, publications in the past decade justify excitement about the potential to transform FUO investigations. We discuss available evidence using these molecular methods for FUO evaluations, including potential cost-benefits and future directions.

Bone Marrow Aspiration/Biopsy in the Evaluation of Fever of Unknown Origin in Patients with AIDS

2020 ◽  
Vol 20 ◽  
Author(s):  
Mahboubeh Hajiabdolbaghi ◽  
Bahar Ataeinia ◽  
Fatemeh Ghadimi ◽  
SeyedAhmad SeyedAlinaghi ◽  
Banafsheh Moradmand Badie ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Diagnostic Tool ◽  
Fever Of Unknown Origin ◽  
Opportunistic Infections ◽  
Bone Marrow Aspiration ◽  
Unknown Origin ◽  
Aspiration Biopsy ◽  
Diagnostic Tools ◽  
Aids Patients ◽  
Cell Counts

Background: HIV can interrupt the normal development of bone marrow cell lines. Bone marrow aspiration/biopsy (BMA/B) has been described as a diagnostic tool in AIDS patients with fever of unknown origin (FUO). In this study, we aimed to study patients with AIDS who had undergone a BMA/B to investigate FUO and describe the pathologies diagnosed in the biopsy. Methods: Thirty-four BMA/B samples were collected from AIDS patients admitted for workup of FUO to the infectious disease ward of a tertiary referral HIV center in Tehran, Iran, between September 2014 and September 2015. Data including age, sex, duration of disease, CD4 cell counts, hepatitis B (HBV) and C (HCV) coinfection, the primary presentation of AIDS, and the treatment history were retrieved and analyzed. Patients underwent BMA/B. An expert pathologist reviewed the BMA/B specimens. Results: The mean age of the patients was 37.5 years (range, 26-56), and 27 (79%) were men. Twenty-seven (79%) patients contracted HIV from injection drug use, and 7 (21%) via sexual transmission. Only 3 (9%) of the BMA/B examinations were normal. Hypocellular bone marrow was diagnosed in 22 (65%) patients. Other pathologies included granulomas in 6 (18%), hematologic malignancies in 2 (6%), and leishmaniasis Aspergillosis, each in 1 (3%) patient. Six (17%) of the specimens were found to have tuberculosis infections. Conclusion: Hypocellular bone marrow was the most common pathology on BMA/B examinations, followed by the presence of granulomas. Tuberculosis, Aspergillosis, and Leishmaniasis were the opportunistic infections diagnosed on BMA/B specimens. Our results support BMA/B as an appropriate diagnostic tool for early diagnosis of opportunistic infections and malignancies in AIDS. BMA/B is indispensable in the armament of diagnostic tools of the physicians managing AIDS patients.

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