Fever of unknown origin (peds): Difference between revisions
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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]] | ||
*** | ***[[Viral hepatitis]] | ||
*** | ***[[Mononucleosis]] | ||
**[[Fungal infections|Fungal]] | |||
***[[Blastomycosis]] | |||
***[[Histoplasmosis]] | |||
**[[Parasitic infections|Parasitic]] | |||
**Fungal | ***[[Malaria]] | ||
***Blastomycosis | ***[[Toxoplasmosis]] | ||
*** | ***[[Cysticercosis]] | ||
** | |||
*** | |||
*** | |||
*'''Non-infectious Inflammatory''' | *'''Non-infectious Inflammatory''' | ||
** | **[[Juvenile idiopathic arthritis]] | ||
** | **[[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]] | ||
** | **[[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
- 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
- Leukemia
- Lymphoma
- Neuroblastoma
- Wilms tumor
- 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
