Fever of unknown origin − diagnostic methods in a European developing country

Bosilkovski, Mile; Dimzova, Marija; Stevanović, Milena; Cvetkovska, Vesna Semenakova; Duganovska, Maja Vasileva

doi:10.2298/vsp140827050b

Cited by 9 publications

(15 citation statements)

References 23 publications

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“…Unfortunately, the timing, anatomic site, and method of temperature monitoring is not mentioned in most FUO studies (11). However, there are concessions from the adopted definitions for normal body temperature for fever, such as >38.0°C taken rectally (12,13), >37.5°C (14) or >38.1°C (15) taken orally, or ≥37.0°C (16), ≥37.5°C (17,18), ≥37.8°C (19), or ≥38.0°C (20) measured in the axillae, in some studies.…”

Section: Definition Of Fevermentioning

confidence: 99%

“…The proportion of diagnostic categories reserved for patients with FUO varies widely in global literature. Therefore, the frequency of infections, NIIDs, and neoplasms are observed in ranges from 11% to 59%, 2% to 38%, and 6% to 31%, respectively (17). The frequency of miscellaneous conditions and undiagnosed cases was reported to be 2% to 22% and 5% to 53%, respectively (17).…”

Section: Classification Of Diagnostic Categories and Their Distributionmentioning

confidence: 99%

“…Therefore, the frequency of infections, NIIDs, and neoplasms are observed in ranges from 11% to 59%, 2% to 38%, and 6% to 31%, respectively (17). The frequency of miscellaneous conditions and undiagnosed cases was reported to be 2% to 22% and 5% to 53%, respectively (17). The reasons for these discrepancies could be due to a plethora of factors, such as different inclusion criteria (which depend on the FUO definition); the time period in which the study was conducted (in the latest period there was an increasing number of drug addicts, immigration, international travel, people with various prosthetic implants, development of new diagnostic techniques, revelation of new infective causes that might present with fever of unknown origin such as ehrlichiosis, Bartonellosis, persistent Yersinia infection, and Parvo B19, HTLV-1, and HHV8 viruses) (28,54); the nature of the study (prospective or retrospective); the demographic characteristics of the included population; and the geographic region and its economic characteristics (including the hospital in which the study was conducted with its diagnostic potential and physician experience).…”

Section: Classification Of Diagnostic Categories and Their Distributionmentioning

confidence: 99%

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Fever of Unknown Origin (FUO): towards uniform definitions and classification system

Bosilkovski¹

2020

Erciyes Med J

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Despite the great advancements seen in medicine in recent years, fever of unknown origin (FUO) remains a serious diagnostic challenge. Regardless of the etiological elucidation in many cases of FUO and the progress seen in the management of these patients, there are currently many weaknesses in this area as a result of inconsistency in the definition and interpretation of key terminology and the utilization of different definitions and classifications. As a result, there is confusion among medical practitioners about FUO, which leads to laborious and difficult comparisons among different case series. This study outlines the mismatch in terminology and diversity found in the classification of the conditions that cause FUO and emphasizes the discrepancies between what some terminology intends to represent and what it actually represents in reality. Thus, we attempted to determine an appropriate solution for established inconsistencies.

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Section: Definition Of Fevermentioning

confidence: 99%

Section: Classification Of Diagnostic Categories and Their Distributionmentioning

confidence: 99%

Section: Classification Of Diagnostic Categories and Their Distributionmentioning

confidence: 99%

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Fever of Unknown Origin (FUO): towards uniform definitions and classification system

Bosilkovski¹

2020

Erciyes Med J

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“…Según lo descrito en la literatura, la edad de los pacientes es determinante para establecer el diagnóstico, por ejemplo, en los pacientes pediátricos, la mayoría de las etiologías son infecciosas-virales y autoresuelven, sin embargo, es pertinente descartar neoplasias malignas, las cuales corresponden a un alto porcentaje en esta edad; así, en adultos, aunque también predominan las infecciosas, para ambos tipos de pacientes, en la última década se ha evidenciado aumento en aquellas de causa reumatológica, llegando casi a compararse con los grupos mencionados (13)(14)(15).…”

Section: Casounclassified

Síndrome febril prolongado de origen reumatológico. Reporte de tres casos.

González

Guzmán²,

Guatibonza

et al. 2018

rev cuarzo

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El presente trabajo describe tres casos con Síndrome Febril Prolongado (SFP) con diagnóstico definitivo de enfermedad reumatológica, el primero, hombre de 29 años con picos febriles de 40°C, mialgias y adenopatías cervicales; único antecedente, viaje 30 días previos a región tropical, lo que hizo pensar en etiología infecciosa, sin embargo, tras persistencia de fiebre a pesar de cubrimiento antimicrobiano, se extienden estudios paraclínicos con hallazgo de ferritina en 2208 μg/l sugestivo de Enfermedad de Still del adulto al décimo día de estancia. El segundo es un hombre de 19 años, con clínica de dolor abdominal asociado a temperatura de 40°C sin antecedentes de importancia; ecografía abdominal evidencia hepatomegalia y derrame pleural; durante la estancia, presentó convulsiones tónico-clónicas y pancitopenia con anemia hemolítica, posterior a descartar cuadro infeccioso y neoplasia maligna, se solicitó perfil inmunológico con ANAS y Anticoagulante Lúpico positivos y se orienta diagnóstico hacia Lupus Eritematoso Sistémico al onceavo día de hospitalización, con mejoría posterior al manejo inmunomodulador. Por último, paciente femenina de 14 años con historia de artralgias, adenopatías cervicales/submaxilares, exantema morbiliforme y fiebres fluctuantes (38-39,9°C) de un mes de evolución que persistía pese a policultivos negativos y antibioticoterapia de amplio espectro por lo cual se amplían estudios de laboratorio encontrando ferritina de 3156 μg/l al día noveno de estancia y se diagnostica Enfermedad de Still del niño. La prevalencia de enfermedades reumatológicas en el SFP, ha venido en aumento permitiendo la aproximación precisa a otras etiologías antes no consideradas entre sus causas.

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“…The aetiology of FUO is determined by multiple causes like geographic, economic and demographic characteristics, used definition and diseases classification, accessibility of diagnostic tools and the development of new antimicrobials and immunomodulating agents [3]. It has been shown that the immense expansion of the medical science and the improvement of life quality and expectancy, existent these last decades, have not much contributed in overcoming FUO, but at the same time have influenced the causative spectrum of diseases [4,5].…”

Section: Introductionmentioning

confidence: 99%

The changing pattern of fever of unknown origin in the Republic of North Macedonia

Bosilkovski

Dimzova

Cvetkova

et al. 2019

Romanian Journal of Internal Medicine

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Introduction. The study aimed to compare the etiologic spectrum of diseases causing fever of unknown origin (FUO) and methods for definitive diagnosis in a tertiary care hospital in the Republic of North Macedonia during two different time periods. Patients and methods. There were analysed retrospectively the causes for FUO and final diagnostic approaches in 185 patients with classic FUO that were treated at the University Hospital for Infectious Diseases in Skopje during two time periods. Seventy nine patients were treated during 1991 to 1995 and 106 patients during 2011 to 2015. Results. When comparing these two periods, infections were present in 46.8% and 29.2% (p = 0.014), non-infective inflammatory disorders in 22.8% and 25.5% (p = 0.674), neoplasms in 10.1% and 13.2% (p = 0.522), miscellaneous in 8.9% and 12.3% (p = 0.461) and undiagnosed cases in 11.4% and 19.8% (p = 0.124), respectively. The most common causes for FUO during the first period were abscesses (8.9%), tuberculosis and systemic lupus erythematosus (7.6% each), whereas in the second period the commonest causes were adult onset Still disease and solid organ neoplasm (7.6% each), polymyalgia rheumatica, abscesses and visceral leishmaniasis (5.7% each). The newer imaging techniques and clinical course evaluation had superior diagnostic significance during the second period. Conclusion. A changing pattern of diseases causing FUO during the examined periods was evident. Infections continue to be the most common cause but with decreasing incidence when compared to 20 years ago. Even nowadays clinical evaluation and follow-up still remain the vital diagnostic tools in determining the etiology of FUO.

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Fever of unknown origin − diagnostic methods in a European developing country

Cited by 9 publications

References 23 publications

Fever of Unknown Origin (FUO): towards uniform definitions and classification system

Fever of Unknown Origin (FUO): towards uniform definitions and classification system

Síndrome febril prolongado de origen reumatológico. Reporte de tres casos.

The changing pattern of fever of unknown origin in the Republic of North Macedonia

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