Fever of unknown origin causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Causes

Extrapulmonary tuberculosis is the most frequent cause of FUO. Drug fever, as sole symptom of an adverse reaction to medication, should always be thought of. Disseminated granulomatoses such as Tuberculosis, Histoplasmosis, Coccidioidomycosis, Blastomycosis and Sarcoidosis are associated with FUO.

Lymphomas are the most common cause of FUO in adults. Thromboembolic disease (i.e. pulmonary embolism, deep venous thrombosis) occasionally shows fever. Although infrequent, its potentially lethal consequences warrant evaluation of this cause. Endocarditis, although uncommon, is another important thing to consider. An underestimated reason is factitious fever. Patients frequently are women that work, or have worked, in the medical field and have complex medical histories.

Causes by Organ System

Cardiovascular	Endocarditis, Deep vein thrombosis, Thrombophlebitis
Chemical / poisoning	Bismuth
Dermatologic	No underlying causes
Drug Side Effect	Allopurinol, Amphotericin B, Aminoglutethimide, Barbiturates, Bismuth, Chlorpromazine, Ethotoin, GMCSF, Levomepromazine, Methyldopa, Perazine, Phenophthalein, Pipothiazine, Promazine, Penicillin, Phenytoin, Quinidine, Rifampicin
Ear Nose Throat	Periodic fever aphthous pharyngitis and cervical adenopathy
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Cirrhosis of liver, Crohn's disease, Ulcerative Colitis, Whipple's disease, Choledochal cyst, Cholangitis
Genetic	No underlying causes
Hematologic	Angioimmunoblastic lymphadenopathy with dysproteinaemia, Hyperimmunoglobulinemia D and periodic fever syndrome
Iatrogenic	No underlying causes
Infectious Disease	Lung abscess, Subdiaphragmatic abscess, Liver abscess, Pyelonephritis, Salmonella typhi, Osteomyelitis, Gonorrhoea, Leptospirosis, Q fever, Endocarditis, Tularaemia, Scrub typhus, Relapsing fever, Rickettsia akari, Boutonneuse fever, Mycobacterium tuberculosis, Yersinia enterocolitica, Periodic fever aphthous pharyngitis and cervical adenopathy, Ehrlichiosis, Atypical pneumonia, Cyclical neutropenia, Xanthogranulomatous pyelonephritis, Streptococcus suis, Catheter infections, Lepromatous leprosy, Treponema pallidum, Neisseria meningiditis, UTI, Borrelia burgdorferi, Mycobacterium kansasii, Mycobacterium avium-intracellulare, Sinusitis, Actinomycosis, Yersinia pseudotuberculosis, Leptospira hebdomadis, Listeria monocytogenes, Brucellosis, Blastomycosis, Candida albicans, Allergic bronchopulmonary aspergillosis, Invasive aspergillosis, Cryptococcus neoformans, Psittacosis, Coccidioidomycosis, Histoplasmosis, Malaria, Toxoplasma, Sleeping sickness, Entamoeba histolytica, Visceral leishmaniasis, Fasciola hepatica, Epstein-Barr virus, Hepatitis B, HIV-1 disease, Newcastle disease
Musculoskeletal / Ortho	Osteomyelitis, Discitis, Polymyalgia rheumatica
Neurologic	Hereditary sensory and autonomic neuropathy type 3, Vitamin B12 deficiency
Nutritional / Metabolic	Vitamin B12 deficiency
Obstetric/Gynecologic	No underlying causes
Oncologic	Renal adenocarcinoma, Hodgkin's lymphoma, Pancreatic cancer, Angioimmunoblastic lymphadenopathy with dysproteinaemia, Paraneoplastic syndrome, Atrial myxoma
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	Factitious fever
Pulmonary	Lung abscess, Allergic bronchopulmonary aspergillosis, Invasive aspergillosis
Renal / Electrolyte	Acute pyelonephritis, Xanthogranulomatous pyelonephritis
Rheum / Immune / Allergy	Polyarteritis nodosa, Systemic lupus erythematosus, Polymyalgia rheumatica, Sarcoidosis, Polymyositis, Temporal arteritis, Juvenile chronic arthritis, Hyperimmunoglobulinemia D and periodic fever syndrome, Wegener's granulomatosis, Recurrent hereditary polyserositis, Disseminated Intravascular Coagulation, Still's Disease, Rheumatoid disease, Whipple's disease, Retroperitoneal fibrosis, Crohn's disease, Ulcerative colitis, Schnitzler syndrome
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Surgery complication, Fabry's disease

Causes by Alphabetical Order

Actinomycosis Allopurinol Angioimmunoblastic lymphadenopathy with dysproteinaemia Allergic bronchopulmonary aspergillosis Amphotericin B Aminoglutethimide Atrial myxoma Atypical pneumonia Barbiturates Blastomycosis Bismuth Borrelia burgdorferi Boutonneuse fever Brucellosis Candida albicans Catheter infections Chlorpromazine Choledochal cyst Cholangitis Cirrhosis of liver Coccidioidomycosis Crohn's disease Cryptococcus neoformans Cyclical neutropenia Deep vein thrombosis Discitis Disseminated Intravascular Coagulation Ehrlichiosis Epstein-Barr virus Entamoeba histolytica Endocarditis Ethotoin Fabry's disease Fasciola hepatica GMCSF Hepatitis B Hereditary sensory and autonomic neuropathy type 3 HIV-1 disease Histoplasmosis Hodgkin's lymphoma Hyperimmunoglobulinemia D and periodic fever syndrome Invasive aspergillosis Juvenile chronic arthritis Levomepromazine Lepromatous leprosy Leptospirosis Leptospira hebdomadis Listeria monocytogenes Liver abscess Lung abscess Malaria Methyldopa Mycobacterium avium-intracellulare Mycobacterium kansasii Mycobacterium tuberculosis Newcastle disease Neisseria Gonorrhoea Neisseria meningiditis Osteomyelitis Pancreatic cancer Paraneoplastic syndrome Periodic fever aphthous pharyngitis and cervical adenopathy Perazine Penicillin Phenophthalein Pipothiazine Phenytoin Polyarteritis nodosa Polymyalgia rheumatica Polymyositis Promazine Psittacosis Pulmonary embolism Pyelonephritis Pyelonephritis classificationXanthogranulomatous pyelonephritis Q fever Quinidine Recurrent hereditary polyserositis Renal adenocarcinoma Relapsing fever Retroperitoneal fibrosis Rheumatoid disease Rifampicin Rickettsia akari Salmonella typhi Sarcoidosis Schnitzler syndrome Scrub typhus Sinusitis Sleeping sickness Still's Disease Streptococcus suis Surgery complication Subdiaphragmatic abscess Systemic lupus erythematosus Treponema pallidum Tularaemia Ulcerative colitis UTI Temporal arteritis Thrombophlebitis Toxoplasma Visceral leishmaniasis Vitamin B12 deficiency Wegener's granulomatosis Whipple's disease Yersinia enterocolitica Yersinia pseudotuberculosis References