Pyrexia of unknown origin and its aetiology in Pakistan

Abstract

Pyrexia of unknown origin (PUO) and its aetiology vary considerably according to geography. We conducted a retrospective study to update our knowledge of PUO in Pakistan. PUO was defined as a febrile illness of >3 weeks’ duration, a temperature of >38.3°C, and >3 outpatient visits or 3 days’ hospitalization. Infection was the cause in 47.1%, malignancy in 23.1%, noninfectious inflammatory disease in 21.8%, miscellaneous causes in 1.2%, and in 6.8%, the cause of the fever was not found.

Role of bone marrow examination in pyrexia of unknown origin

“…The report by Akhtar et al reminds us of the importance of a stepwise approach to evaluating pyrexia of unknown origin (PUO) in low-middle-income countries. 1,2 We wish also to highlight the role of bone marrow (BM) examination as a valuable diagnostic tool in PUO when other investigations are negative. It is particularly helpful in cases involving reticuloendothelial organs, manifesting as cytopenia involving one or more cell lineages, splenomegaly, or lymphadenopathy such as haematological malignancy ( viz.…”