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Fever of Unknown Origin (FUO)

Daniel R. Matta, MD and Fabiola Puga Due?as, Medical doctor Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Classic definition

    • Repeated fever >38.3°C

    • Fever duration at least 3 weeks

    • Diagnosis remains uncertain (1) after 1 week of study in the hospital.

  • In over 50% of cases, no etiology is ...

DIAGNOSIS

The initial approach should include a comprehensive history and physical examination, as well as laboratory testing. The decision of what further testing should be gathered should be guided ...

TREATMENT

GENERAL MEASURES

  • Treatment depends on the specific etiology.

  • Empiric therapy is not recommended in patients with prolonged fever, because it may camouflage and therefore delay diagnosis, and s...

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
Hayakawa K, Ramasamy B, Chandrasekar PH. Fever of unknown origin: an evidence-based review. Am J Med Sci. 2012 Oct;344(4):307-16.
2
Mulders-Manders C, Simon A, Bleeker-Rovers C. Fever of un...

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. [View Abstract on OvidMedli...

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 

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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