Fever of unknown origin differential diagnosis: Difference between revisions
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*Malignant | *Malignant | ||
*Inflammatory | *Inflammatory | ||
*Miscellaneous | *Miscellaneous<ref name="CunhaLortholary2015">{{cite journal|last1=Cunha|first1=Burke A.|last2=Lortholary|first2=Olivier|last3=Cunha|first3=Cheston B.|title=Fever of Unknown Origin: A Clinical Approach|journal=The American Journal of Medicine|volume=128|issue=10|year=2015|pages=1138.e1–1138.e15|issn=00029343|doi=10.1016/j.amjmed.2015.06.001}}</ref> | ||
==Differential diagnosis== | ==Differential diagnosis== | ||
=== Infectious === | ===Infectious=== | ||
These patients mostly have a history of hospitalization, surgical procedures, contact with infected person or travel to an endemic place. | These patients mostly have a history of hospitalization, surgical procedures, contact with infected person or travel to an endemic place.<ref name="CunhaLortholary20152">{{cite journal|last1=Cunha|first1=Burke A.|last2=Lortholary|first2=Olivier|last3=Cunha|first3=Cheston B.|title=Fever of Unknown Origin: A Clinical Approach|journal=The American Journal of Medicine|volume=128|issue=10|year=2015|pages=1138.e1–1138.e15|issn=00029343|doi=10.1016/j.amjmed.2015.06.001}}</ref><ref name="pmid23111594">{{cite journal| author=Salzberger B, Schneidewind A, Hanses F, Birkenfeld G, Müller-Schilling M| title=[Fever of unknown origin. Infectious causes]. | journal=Internist (Berl) | year= 2012 | volume= 53 | issue= 12 | pages= 1445-53; quiz 1454-5 | pmid=23111594 | doi=10.1007/s00108-012-3173-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23111594 }}</ref> | ||
Examples include: | Examples include: | ||
* Lyme disease | *Lyme disease | ||
* Histoplasmosis | *Histoplasmosis | ||
* Q fever | *Q fever | ||
* Brucellosis | *Brucellosis | ||
* Toxoplasmosis | *Toxoplasmosis | ||
* Leptospirosis | *Leptospirosis | ||
* Ehrlichiosis | *Ehrlichiosis | ||
* Anaplasmosis | *Anaplasmosis | ||
* Tuberculosis | *Tuberculosis | ||
* Infectious mononucleosis | *Infectious mononucleosis | ||
* mycobacterium avium infection etc. | *mycobacterium avium infection etc. | ||
=== Malignant === | ===Malignant=== | ||
They are mostly accompanied by loss of weight, decrease in appetite, lymph node enlargement and aquagenic pruritic mostly occurring after hot shower. | They are mostly accompanied by loss of weight, decrease in appetite, lymph node enlargement and aquagenic pruritic mostly occurring after hot shower. | ||
Examples include: | Examples include: | ||
* Hodgkin lymphoma | *Hodgkin lymphoma | ||
* myeloproliferative disorders | *myeloproliferative disorders | ||
* Colorectal carcinoma | *Colorectal carcinoma | ||
* Hepatoma | *Hepatoma | ||
* Renal cell carcinoma | *Renal cell carcinoma | ||
* carcinoma of CNS | *carcinoma of CNS | ||
* Sarcoma etc. | *Sarcoma etc. | ||
=== | ===Autoinflammatory/Rheumatologic=== | ||
Mostly they have multi organ involvement and lymphadenopathy along with joint symptoms may be present. | Mostly they have multi organ involvement and lymphadenopathy along with joint symptoms may be present.<ref name="pmid28672419">{{cite journal| author=Kümmerle-Deschner JB| title=[Autoinflammatory Diseases as a Differential Diagnosis of Fever of Unknown Origin]. | journal=Dtsch Med Wochenschr | year= 2017 | volume= 142 | issue= 13 | pages= 969-978 | pmid=28672419 | doi=10.1055/s-0043-103468 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28672419 }}</ref><ref name="pmid27964789">{{cite journal| author=Mulders-Manders CM, Simon A, Bleeker-Rovers CP| title=Rheumatologic diseases as the cause of fever of unknown origin. | journal=Best Pract Res Clin Rheumatol | year= 2016 | volume= 30 | issue= 5 | pages= 789-801 | pmid=27964789 | doi=10.1016/j.berh.2016.10.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27964789 }}</ref> | ||
Examples include: | Examples include: | ||
* Systemic lupus erythematosus | *Systemic lupus erythematosus | ||
* Polymyositis | *Polymyositis | ||
* Dermatomyositis | *Dermatomyositis | ||
* Polymyalgia rheumatica etc. | *Polymyalgia rheumatica etc. | ||
=== Miscellaneous === | ===Miscellaneous=== | ||
Mostly does not belong to any of the above. | Mostly does not belong to any of the above. | ||
Examples include: | Examples include: | ||
* Familial Mediterranean fever. | *Familial Mediterranean fever. | ||
* Drug fever | *Drug fever | ||
* Thyroiditis | *Thyroiditis | ||
* Hypertriglyceridemia etc. | *Hypertriglyceridemia etc. | ||
==References== | ==References== | ||
Revision as of 20:52, 23 January 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: febris continua e causa ignota; febris e causa ignota; febris E.C.I.; FUO; PUO; pyrexia of unknown origin
Overview
- Fever can be the presenting symptom with many diseases, it is therefore important to differentiate fever of unknown origin from all those diseases which present with fever.
- Because of the broad range of differential diagnosis they can be grouped into four categories based on their etiology.
- Infectious
- Malignant
- Inflammatory
- Miscellaneous[1]
Differential diagnosis
Infectious
These patients mostly have a history of hospitalization, surgical procedures, contact with infected person or travel to an endemic place.[2][3]
Examples include:
- Lyme disease
- Histoplasmosis
- Q fever
- Brucellosis
- Toxoplasmosis
- Leptospirosis
- Ehrlichiosis
- Anaplasmosis
- Tuberculosis
- Infectious mononucleosis
- mycobacterium avium infection etc.
Malignant
They are mostly accompanied by loss of weight, decrease in appetite, lymph node enlargement and aquagenic pruritic mostly occurring after hot shower.
Examples include:
- Hodgkin lymphoma
- myeloproliferative disorders
- Colorectal carcinoma
- Hepatoma
- Renal cell carcinoma
- carcinoma of CNS
- Sarcoma etc.
Autoinflammatory/Rheumatologic
Mostly they have multi organ involvement and lymphadenopathy along with joint symptoms may be present.[4][5]
Examples include:
- Systemic lupus erythematosus
- Polymyositis
- Dermatomyositis
- Polymyalgia rheumatica etc.
Miscellaneous
Mostly does not belong to any of the above.
Examples include:
- Familial Mediterranean fever.
- Drug fever
- Thyroiditis
- Hypertriglyceridemia etc.
References
- ↑ Cunha, Burke A.; Lortholary, Olivier; Cunha, Cheston B. (2015). "Fever of Unknown Origin: A Clinical Approach". The American Journal of Medicine. 128 (10): 1138.e1–1138.e15. doi:10.1016/j.amjmed.2015.06.001. ISSN 0002-9343.
- ↑ Cunha, Burke A.; Lortholary, Olivier; Cunha, Cheston B. (2015). "Fever of Unknown Origin: A Clinical Approach". The American Journal of Medicine. 128 (10): 1138.e1–1138.e15. doi:10.1016/j.amjmed.2015.06.001. ISSN 0002-9343.
- ↑ Salzberger B, Schneidewind A, Hanses F, Birkenfeld G, Müller-Schilling M (2012). "[Fever of unknown origin. Infectious causes]". Internist (Berl). 53 (12): 1445–53, quiz 1454-5. doi:10.1007/s00108-012-3173-8. PMID 23111594.
- ↑ Kümmerle-Deschner JB (2017). "[Autoinflammatory Diseases as a Differential Diagnosis of Fever of Unknown Origin]". Dtsch Med Wochenschr. 142 (13): 969–978. doi:10.1055/s-0043-103468. PMID 28672419.
- ↑ Mulders-Manders CM, Simon A, Bleeker-Rovers CP (2016). "Rheumatologic diseases as the cause of fever of unknown origin". Best Pract Res Clin Rheumatol. 30 (5): 789–801. doi:10.1016/j.berh.2016.10.005. PMID 27964789.