National survey of childhood febrile illness cases with fever of unknown origin in Japan

Kasai, Kazuko; Mori, Masaaki; Hara, Ryoki; Miyamae, Takako; Imagawa, Tomoyuki; Yokota, Shumpei

doi:10.1111/j.1442-200x.2010.03296.x

Cited by 12 publications

(9 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with enlarged lymph nodes accompanied with fever, the possibility of necrotizing lymphadenitis should be considered. In a Japanese study13), 14 patients with FUO had necrotizing lymphadenitis, which was the most common diagnosis in 34 patients in the miscellaneous group.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

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

Kim

Kang

et al. 2017

Korean J Pediatr

View full text Add to dashboard Cite

PurposeFever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories.MethodsAmong the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ≥38.0℃ for longer than ≥14 days and failure to reach a diagnosis after one week of investigations were included.ResultsTotal 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%).ConclusionAlmost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.

show abstract

Section: Discussionmentioning

confidence: 98%

“…Therefore, in Table 6, we only reviewed the data between 2000 and 2014 from various countries113141516171819202122). Although infectious disease still appears to be the most common cause of FUO in children, it would be interesting to assess for changes in the etiologies of FUO in the future.…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Kang

et al. 2017

Korean J Pediatr

View full text Add to dashboard Cite

show abstract

“…Although Zhu Futang’s guidelines for FUO suggest to consider temperature, even varying, but maintaining at >37.5°C for more than 2 weeks, in order to avoid missing out those patients who might not show as high as 38.3°C body temperature all the time, but might have other diagnostic indications with body temperature >37.5°C for FUO. We followed the criteria for febrile body temperature of ≥38.3°C either occasionally or persistently for more than 2 weeks to maintain the study in agreement with the previous reports 12. The aetiology of FUO in children mainly includes infectious diseases, non-infectious inflammatory diseases (NIIDs), neoplastic diseases, miscellaneous diseases and undiagnosed diseases 13 14.…”

Section: Introductionmentioning

confidence: 85%

Fever of unknown origin (FUO) in children: a single-centre experience from Beijing, China

Chen

Liu

et al. 2022

BMJ Open

View full text Add to dashboard Cite

ObjectiveTo date, there is no standard diagnostic practice to identify the underlying disease-causing mechanism for paediatric patients suffering from chronic fever without any specific diagnosis, which is one of the leading causes of death in paediatric patients. Therefore, we aimed this retrospective study to analyse medical records of paediatric patients with fever of unknown origin (FUO) to provide a preliminary basis for improving the diagnostic categories and facilitate the treatment outcomes.DesignA retrospective study.SettingBeijing Children’s Hospital.ParticipantsClinical data were collected from 1288 children between 1 month and 18 years of age diagnosed with FUO at Beijing Children’s Hospital between January 2010 and December 2017.InterventionsAccording to the aetiological composition, age, duration of fever and laboratory examination results, the diagnostic strategies were analysed and formulated.Primary and secondary outcome measuresThe statistical analyses were carried out using SPSS V.24.0 platform along with the χ2 test and analysis of variance (p<0.05).ResultsThe duration of fever ranged from 2 weeks to 2 years, with an average of 6 weeks. There were 656 cases (50.9%) of infectious diseases, 63 cases (4.9%) of non-infectious inflammatory diseases (NIIDs), 86 cases (6.7%) of neoplastic diseases, 343 cases (26.6%) caused by miscellaneous diseases and 140 cases (10.9%) were undiagnosed. With increasing age, the proportion of FUO from infectious diseases gradually decreased from 73.53% to 44.21%. NIID was more common in children over 3 years old, and neoplastic diseases mainly occurred from 1 to 6 years of age. Among miscellaneous diseases, the age distribution was mainly in school-aged children over 6 years. Respiratory tract infection was the most common cause of FUO in children, followed by bloodstream infections. Bacterial infection was the most common cause in children with less than 1 year old, while the virus was the main pathogen in children over 1 year old.ConclusionsThe diagnosis of neoplastic diseases and miscellaneous diseases-related diseases still depends mainly on invasive examination. According to our clinical experience, the diagnostic process was formulated based on fever duration and the type of disease. This process can provide a guide for the diagnosis and treatment of paediatric FUO in the future.

show abstract

“…The first nationwide retrospective study of FUO in Japan has recently been reported (18). Pediatric case studies of FUO in Japan have also been collectively reported (19). However, accumulating cases of hospi- talized patients meeting the criteria for classic FUO is not easy.…”

Section: Introductionmentioning

confidence: 99%

Analysis of 256 Cases of Classic Fever of Unknown Origin

et al. 2014

View full text Add to dashboard Cite

Objective The causes of fever of unknown origin (FUO) vary depending on the region and time period. We herein present a study of patients with classic FUO where we investigated differences based on patient background factors, such as age and causative diseases, and changes that have occurred over time. Methods We extracted and analyzed data from the medical records of 256 patients ! 18 years old who met the criteria for classic FUO and were hospitalized between August, 1994 and December, 2012. Results The median age of the patients was 55 years (range: 18-94 years). The cause of FUO was infection in 27.7% of the patients (n=71), non-infectious inflammatory disease (NIID) in 18.4% (47), malignancy in 10.2% (26), other in 14.8% (38), and unknown in 28.9% (74). The most common single cause was human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (n=17). NIID and malignancy were more common in patients ! 65 years old than in patients <65 years old. During 2004During -2012During , compared to 1994During -2003 and "other" causes were decreased, whereas NIID, malignancy, and unknown causes were increased. Conclusion FUO associated with HIV/AIDS is increasing in Japan. In addition, as in previous studies in Japan and overseas, our study showed that the number of patients in whom the cause of FUO remains unknown is increasing and exceeds 20% of all cases. The present study identified diseases that should be considered in the differential diagnosis of FUO, providing useful information for the future diagnosis and treatment of FUO.

show abstract

National survey of childhood febrile illness cases with fever of unknown origin in Japan

Abstract: Clarification of illnesses that ought to be differentiated in the diagnostic approach to an FUO case is essential for arriving at its definitive diagnosis by exclusion.

Cited by 12 publications

References 7 publications

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

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

Fever of unknown origin (FUO) in children: a single-centre experience from Beijing, China

Analysis of 256 Cases of Classic Fever of Unknown Origin

Contact Info

Product

Resources

About