Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center

Kim, Yiseul; Kim, Kyung-Ran; Kang, Jong-Gu; Kim, Jong Min; Kim, Yae-Jean

doi:10.3345/kjp.2017.60.3.77

Cited by 22 publications

(14 citation statements)

References 23 publications

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“…A study in a tertiary care Egyptian Hospital by Hassan RH showed infections to be the most common cause of FUO in 46 cases out of total 127 patients. 11 In studies done in Turkey, Italy and Taiwan 8,12,13,14,15 , similar trends were noted. Chien YL et al in Taiwan reported infections to be the dominant cause, followed by malignancy, miscellaneous causes and collagen vascular disease.…”

Section: Discussionsupporting

confidence: 64%

Etiology of fever of unknown origin in children.

Lodhi

Rizwan

Nazar

et al. 2021

TPMJ

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Objectives: To determine the etiology of Fever of Unknown Origin (FUO) in children. Study Design: Prospective Observational study. Setting: Department of Pediatric Medicine, The Children's Hospital, Lahore. Period: August 2019 to January 2020. Material & Methods: A total of 45 children aged between 01 to 180 months (15 years), having FUO were included. FUO was defined as a temperature of greater than 100.4ºF documented by a health care provider, persisting over a period of three weeks and for which no cause could be identified after at least 8 days of evaluation. All the study information was analyzed by using standard software SPSS 20. The quantitative variables like age and duration of fever before hospital admission were presented as mean and standard deviation. Qualitative variables like sex, antibiotic therapy use before definitive diagnosis and various diagnoses made were presented as frequencies and percentages. Results: The patient’s age range was from 01 to 180 months with mean of 80±45.12 months and male to female ratio was 2.2:1. Definitive diagnosis was made in 37(82.2%) patients. Infections were the predominant cause of FUO (44.4%) followed by malignancy (24.4%). Tuberculosis was the most common infection while Acute Lymphoblastic leukemia dominated the malignancy. Systemic lupus erythematosus was the most commonly diagnosed connective tissue disorder. There was a significant association between duration of fever and the ultimate diagnosis (p=0.01). Conclusion: Infectious diseases were the most common cause of FUO followed by malignancy, connective tissue disorders and miscellaneous causes.

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Section: Discussionsupporting

confidence: 64%

Etiology of fever of unknown origin in children.

Lodhi

Rizwan

Nazar

et al. 2021

TPMJ

View full text Add to dashboard Cite

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“…Undiagnosed causes are the most challenging cases worldwide. Kim et al [17] faced this challenge in 43% of their patients and accounted for 18.84% in our study. A recent study from our country reported that only 12.0% cases remained undiagnosed.…”

Section: Sixtymentioning

confidence: 81%

Profile of Fever of Unknown Origin in Children and the Role of Investigation: An Observational Study

Reddy¹,

Reddy²

2019

Journal of Microbiology and Infectious Diseases

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Objectives: Fever of Unknown Origin (FUO) in children remains difficult to diagnose. This prospective, observational study aimed to determine the clinico-etiological profile and the role of clinical procedures in establishing the diagnosis. Methods: Children (between 1 month and 16 years) with prolonged fever meeting the criteria of FUO were included. A detailed medical history, physical examination and laboratory tests were conducted according to an algorithm (phase I-III). Clinical procedures that were useful in obtaining final etiology were evaluated. Results: In total, 69 children were enrolled, categorized into five groups based on etiology of FUO. Infections (31.8%) were the leading cause followed by malignancy (20.2%), connective tissue disorder and miscellaneous conditions (14.5%); undiagnosed patients (18.8%) had either a spontaneous resolution or incomplete workup. Duration of fever was 20-60 days, longer in malignancies, least in infections and mean ± SD duration between admission and a definitive diagnosis was 5.65 ± 1.06 days. Tuberculosis was the most common among the infections, systemic onset juvenile idiopathic arthritis and Common acute lymphoblastic leukemia antigen positive B cell acute lymphoblastic leukemia were common causes of connective tissue disorder and malignancy, respectively. The diagnosis was established by Phase II (33.3%) and Phase III (34.8%) investigations. Non-invasive and invasive investigations were useful in 56.3%, and 43.7 %, respectively. Conclusions: Infections are the most common cause of FUO in children followed by malignancy. A stepwise approach is useful in diagnosis. Infections and connective tissue disorders are diagnosed by non-invasive investigations while malignancy and miscellaneous conditions by invasive investigations. Focused clinical and diagnostic approach is mandated.

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“…[13][14][15] En Corea del Sur se reportó que el porcentaje de niños en los que no se llegó a un diagnóstico fue de 43%, resultado similar al presente estudio. 16 Sin embargo, en otras series, el porcentaje de casos sin un diagnóstico final es menor. [13][14][15] Otro punto importante es que, en algunos casos, la etiología del FOD podría haberse identificado en establecimientos de menor nivel de complejidad, como las infecciones urinarias o fiebre tifoidea.…”

Section: Evolución De Pacientes Con Fodunclassified