Fever of Unknown Origin in a Portuguese Tertiary Hospital: A Cohort Study
DOI:
https://doi.org/10.24950/rspmi.650Keywords:
Fever of Unknown Origin/diagnosis, Fever of Unknown Origin/etiologyAbstract
Introduction: Fever of unknown origin (FUO) remains a major diagnostic challenge, despite advances in the medical field. It can be caused by a broad spectrum of diseases with very different prognostic outcomes. Constant re-evaluation of clinical data is essential considering the dynamic changes in disease patterns. We aim to understand which clinical approach is most commonly used and recognize our local epidemiology in order to improve the diagnostic approach to these patients.
Methods: We performed a retrospective study in an internal medicine department of a public tertiary hospital. Clinical records of all patients admitted during 2016 and 2017 were onsulted; data from patients that fulfilled FUO criteria were collected.
Results: A total of 55 FUO patients were identified (0.6% of all admissions). Infections were the most frequent cause (n = 23; 41.8%) followed by non-infectious inflammatory diseases (n = 12; 21.8%), malignancies (n = 8; 14.5%) and miscellaneous group (n = 3; 5.5%). However, in 9 cases (16.4%) the etiology remained unknown. The most common disease causing FUO was Q fever, followed by infective bacterial endocarditis and abscesses in different locations. Microbiological study of urine and blood was performed in all patients, while serological tests showed wider variability. The use of 18F-fluorodesoxyglucose positron emission tomography (18F-FDG-PET) in 11 (20.0%) cases stands out.
Conclusion: FUO etiologies in our cohort were comparable to other published studies despite the smaller sample. Infections were the most frequent cause identified. Though a significant number of cases remained unknown, it carried a good prognosis.
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