Fever of unknown origin (peds): Difference between revisions

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{{Peds top}} [[fever of unknown origin]]
==Background==
==Background==
*Prolonged fever of unknown origin without identified cause generally has favorable prognosis.
*Prolonged fever of unknown origin without identified cause generally has favorable prognosis.
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==Differential Diagnosis==
==Differential Diagnosis==
*'''Infection'''
*'''Infection'''
** Bacterial
**Bacterial
*** Adenitis
***Adenitis
*** [[Endocarditis]]
***[[Endocarditis]]
*** [[Mastoiditis]]
***[[Mastoiditis]]
*** Occult [[abscess]]
***Occult [[abscess]]
*** [[Pyelonephritis]]
***[[Pyelonephritis]]
*** [[Sinusitis]]
***[[Sinusitis]]
*** [[Tb]]
***[[Tb]]
** Viral
***[[Mycoplasma|Mycoplasmal]]
*** CMV
***Chlamydial
*** Hep A,B, C
****[[Lymphogranuloma venereum]]
*** Mono
****[[Psittacosis]]
** Chlamydial
***[[Rickettsia]]l
*** Lymphogranuloma venereum
****[[Q fever]]
*** Psittacosis
****[[Rocky mountain spotted fever]]
** Mycoplasmal
**Viral
** Fungal
***[[CMV]]
*** Blastomycosis
***[[Viral hepatitis]]
*** Cysticercosis
***[[Mononucleosis]]
*** Histoplasmosis
**[[Fungal infections|Fungal]]
*** Rickettsial
***[[Blastomycosis]]
**** [[Q fever]]
***[[Histoplasmosis]]
**** Rocky Mt
**[[Parasitic infection|Parasitic]]
***Parasitic
***[[Malaria]]
**** Malaria
***[[Toxoplasmosis]]
**** Toxo
***[[Cysticercosis]]
* '''Non-infectious Inflammatory'''
*'''Non-infectious Inflammatory'''
** JRA
**[[Juvenile idiopathic arthritis]]
** LSE
**[[SLE]]
** Regional enteritis
**Regional enteritis
** Rheumatic fever
**[[Rheumatic fever]]
** [[Ulcerative colitis]]
**[[Ulcerative colitis]]
** Vasculitis
**[[Vasculitis]]
* '''Malignancy'''
*'''Malignancy'''
**Leukemia
**[[Leukemia]]
** Lymphoma
**[[Lymphoma]]
** Neuroblastoma
**[[Neuroblastoma (peds)|Neuroblastoma]]
** Wilm's tumor
**[[Wilms' tumor]]
* '''Drug Induced'''
*'''Drug Induced'''
** [[Antibiotics]]
**[[Antibiotics]]
** Anticonvulsants
**[[Anticonvulsants]]
** Anti TB
**Anti [[TB]]
** Procainamide
**[[Procainamide]]
**Quinidine
**[[Quinidine]]
** Serum sickness
**[[Serum sickness]]
* '''Misc'''
*'''Misc'''
** [[AIDS]]
**[[AIDS]]
** CNS
**CNS dysfunction
** Environmental
**Environmental [[hyperthermia]]
**Factitious
**Factitious
**Familial dysautonomia
**Familial dysautonomia
** [[Kawasaki]]
**[[Kawasaki]]
** [[PE]]
**[[PE]]
**Serial infections
**Serial infections
**[[Thyrotoxicosis]]
**[[Thyrotoxicosis]]


==Diagnosis==
==Evaluation==
*Clinical (preliminary) diagnosis
*Clinical (preliminary) diagnosis


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<References/>
<References/>


[[Category:Peds]]
[[Category:Pediatrics]]

Latest revision as of 23:08, 28 November 2019

This page is for pediatric patients. For adult patients, see: fever of unknown origin

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

Evaluation

  • Clinical (preliminary) diagnosis

Management

  • Treat underlying cause (once identified)
  • Empiric treatment generally not recommended

Disposition

  • Frequently admitted for workup

See Also

References

  1. ↑ Kaya A, Ergul N, Kaya SY, et al. The management and the diagnosis of fever of unknown origin. Expert Rev Anti Infect Ther. 2013 Aug;11(8):805-15.
  2. ↑ Durack DT, Street AC. Fever of unknown origin--reexamined and redefined. Curr Clin Top Infect Dis. 1991;11:35-51.
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