Fever of unknown origin (peds): Difference between revisions
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***[[Blastomycosis]] | ***[[Blastomycosis]] | ||
***[[Histoplasmosis]] | ***[[Histoplasmosis]] | ||
**[[Parasitic | **[[Parasitic infection|Parasitic]] | ||
***[[Malaria]] | ***[[Malaria]] | ||
***[[Toxoplasmosis]] | ***[[Toxoplasmosis]] | ||
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**[[Lymphoma]] | **[[Lymphoma]] | ||
**[[Neuroblastoma (peds)|Neuroblastoma]] | **[[Neuroblastoma (peds)|Neuroblastoma]] | ||
**[[Wilms]] | **[[Wilms tumor]] | ||
*'''Drug Induced''' | *'''Drug Induced''' | ||
**[[Antibiotics]] | **[[Antibiotics]] | ||
Revision as of 00:18, 15 September 2019
Background
- Prolonged fever of unknown origin without identified cause generally has favorable prognosis.
Clinical Features
- Original definition[1]
- Fever >38.3 C on several occasions
- Lasting for at least 3 weeks
- No clear diagnosis after 1 week inpatient workup
- Newer definition[2] - "Prolonged fever" with:
- 3 outpatient visits without identifying a cause or
- 3 inpatient days without identifying a cause or
- 1 week of “intelligent and invasive” ambulatory investigation
Differential Diagnosis
- Infection
- Bacterial
- Adenitis
- Endocarditis
- Mastoiditis
- Occult abscess
- Pyelonephritis
- Sinusitis
- Tb
- Mycoplasmal
- Chlamydial
- Rickettsial
- Viral
- Fungal
- Parasitic
- Bacterial
- Non-infectious Inflammatory
- Juvenile idiopathic arthritis
- SLE
- Regional enteritis
- Rheumatic fever
- Ulcerative colitis
- Vasculitis
- Malignancy
- Drug Induced
- Misc
- AIDS
- CNS dysfunction
- Environmental hyperthermia
- Factitious
- Familial dysautonomia
- Kawasaki
- PE
- Serial infections
- Thyrotoxicosis
Evaluation
- Clinical (preliminary) diagnosis
Management
- Treat underlying cause (once identified)
- Empiric treatment generally not recommended
Disposition
- Frequently admitted for workup