Fever of unknown origin medical therapy
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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
Management of fever of unknown origin (FUO) should generally be withheld until the etiology of the fever has been determined, so that treatment can be directed against a specific pathology. However, empiric corticosteroids may be appropriate in patients with suspected temporal arteritis to prevent vascular complications. Patients with febrile neutropenia should receive broad-spectrum antipseudomonal antibiotics immediately after specimens for cultures have been obtained.
Medical Therapy
- Fever of unknown origin (FUO) treatment [1]
- Management should generally be withheld until the etiology of the fever has been ascertained, so that treatment can be directed against a specific pathology.
- Specific clinical considerations
- 1.Neutropenic fever
- Exception may be made for neutropenic patients in which delayed treatment could lead to serious complications.
- After samples for cultures are obtained, patients with febrile neutropenia should be aggressively treated with broad-spectrum antibiotics covering Pseudomonas
- 2.HIV/AIDS individuals
- HIV/AIDS individuals with pyrexia and hypoxia should be placed on empiric therapy for Pneumocystis jirovecii.
- 3.Giant cell arteritis
- Empiric corticosteroids may be considered in patients with suspected giant cell arteritis to prevent vascular complications.
- Giant cell arteritis should be suspected in a patient over the age of 50 with the following symptoms:
- Newly onset headaches
- Abrupt onset of blurry vision
- Symptoms of polymyalgia rheumatica
- Jaw claudication
- Unexplained anemia
- Elevated ESR and/or CRP
References
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.