Fever of unknown origin (peds): Difference between revisions

(Text replacement - "==Diagnosis==" to "==Evaluation==")
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***[[Sinusitis]]
***[[Sinusitis]]
***[[Tb]]
***[[Tb]]
***[[Mycoplasma|Mycoplasmal]]
***Chlamydial
****[[Lymphogranuloma venereum]]
****[[Psittacosis]]
***[[Rickettsia]]l
****[[Q fever]]
****[[Rocky mountain spotted fever]]
**Viral
**Viral
***CMV
***[[CMV]]
***Hep A,B, C
***[[Viral hepatitis]]
***Mono
***[[Mononucleosis]]
**Chlamydial
**[[Fungal infections|Fungal]]
***Lymphogranuloma venereum
***[[Blastomycosis]]
***Psittacosis
***[[Histoplasmosis]]
**Mycoplasmal
**[[Parasitic infections|Parasitic]]
**Fungal
***[[Malaria]]
***Blastomycosis
***[[Toxoplasmosis]]
***Cysticercosis
***[[Cysticercosis]]
***Histoplasmosis
***Rickettsial
****[[Q fever]]
****Rocky Mt
***Parasitic
****Malaria
****Toxo
*'''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

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

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.