Prolonged febrile illness and fever of unknown origin in adults.

摘要: Fever of unknown origin has been described as a febrile illness (temperature 101°F [38.3°C] or higher) for three weeks longer without an etiology despite one-week inpatient evaluation. A more recent qualitative definition requires only reasonable diagnostic Although there are than 200 diseases in the differential diagnosis, most cases adults limited to several dozen possible causes. is often atypical presentation common disease rather unusual disease. The subgroups infection, malignancy, noninfectious inflammatory diseases, and miscellaneous. Clinicians should perform comprehensive history examination look potentially clues guide initial If no clues, patient undergo minimum workup, including complete blood count, chest radiography, urinalysis culture, electrolyte panel, liver enzymes, erythrocyte sedimentation rate, C-reactive protein level testing. Further testing include cultures, lactate dehydrogenase, creatine kinase, rheumatoid factor, antinuclear antibodies. Human immunodeficiency virus appropriate region-specific serologic (e.g., cytomegalovirus, Epstein-Barr virus, tuberculosis) abdominal pelvic ultrasonography computed tomography commonly performed. diagnosis remains elusive, 18F fluorodeoxyglucose positron emission plus may help clinician toward tissue biopsy. Empiric antibiotics steroids generally discouraged patients with fever origin.