Fever of unknown origin laboratory findings

Resident Survival Guide

Fever of unknown origin Microchapters
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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.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO

Overview

Laboratory Workup of Fever of Unknown Origin

• Complete blood count with differential
• Basic metabolic panel
• Liver function test including AST, ALT, LDH, bilirubin, and alkaline phosphatase
• Creatine kinase
• Blood cultures (at least 2 sets)
• Urinalysis with microscopic examination
• Urine cultures
• Erythrocyte sedimentation rate
• C-reactive protein
• Gamma-glutamyl transferase
• Coombs test
• Cold agglutinins
• Ferritin
• Angiotensin-converting enzyme
• Thyroid peroxidase and anti-thyroglobulin antibodies
• Antinuclear antibodies
• Rheumatoid factor
• Cryoglobulins
• Cytomegalovirus serology and heterophile antibody test if positive for atypical lymphocytes
• Q fever serology for patients with exposure to livestocks
• HIV serology
• Serum protein electrophoresis
• Tuberculin skin test
• Fecal occult blood test