Fever of unknown origin (peds)

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Background

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
  • COLLAGEN VASCULAR
  • MALIGNANCY
    • Leukemia
    • Lymphoma
    • Neuroblastoma
    • Wilm's tumor
  • DRUG INDUCED
    • Antibiotics
    • Anticonvulsants
    • Anti TB
    • Procainamide
    • Quinidine
    • Serum sickness
  • MISC

Diagnosis

  • Clinical (preliminary) diagnosis

Management

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.