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Fever of Unknown Origin (FUO)

Scott T. Henderson, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Classic definition

    • Repeated fever >38.3°C

    • Fever duration at least 3 weeks

    • Uncertain diagnosis after 1 week of study in the hospital

  • The definition of fever of unknown origin (FUO) h...

DIAGNOSIS

HISTORY

  • Onset and pattern of fever

  • Constitutional symptoms:

    • Chills, night sweats, myalgias, weight loss with an intact appetite (infectious etiology)

    • Arthralgias, myalgias, fatigue (inflammato...

TREATMENT

GENERAL MEASURES

  • Treatment depends on the specific etiology.

  • Therapeutic trials are a last resort and should be as specific as possible based on available clinical evidence. Avoid “shotgun” ap...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

If the etiology of the fever remains unknown, repeat the history, physical exam, and screening lab studies. 

DIET

No specific dietary recommendati...

REFERENCES

1
1 Mourad O, Palda V, Detsky AS. A comprehensive evidence-based approach to fever of unknown origin. Arch Intern Med.  2003;163(5):545–551. {L-End} {L-End} [View Abstract on OvidMed...

ADDITIONAL READING

  • Cunha BA, Lortholary O, Cunha CB. Fever of unknown origin: a clinical approach. Am J Med.  2015;128(10):1138.e1–1138.e15. {L-End} {L-End} [View Abstract on OvidMedline]

  • Hayak...

SEE ALSO

  • Arteritis, Temporal; Arthritis, Juvenile Idiopathic; Colon Cancer; Cytomegalovirus (CMV) Inclusion Disease; Endocarditis, Infective; Hepatoma (Hepatocellular Carcinoma); HIV/AIDS; Lupus Eryth...

CODES

ICD10

R50.9 Fever, unspecified 

ICD9

780.60 Fever, unspecified 

SNOMED

7520000 Pyrexia of unknown origin (finding) 

CLINICAL PEARLS

  • A sequential approach to FUO based on a careful history, physical examination, with targeted testing and imaging typically yields an appropriate diagnosis and avoids excessive nontarge...

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