Fever of unknown origin diagnostic criteria
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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
Diagnostic Criteria
According Petersdorf and Beeson diagnostic criteria proposed in 1991:[1][2]
- Fever above 38.3° C (100.9° F)
- For more than three weeks
- No diagnosis after work up for at least three visits in outdoor or three days of stay in hospital
Classification
In 1991, Durack and Street proposed a revised definition in which cases of FUO are categorized into four subclasses: classic FUO, nosocomial (health care-associated) FUO, neutropenic (immune-deficient) FUO, and HIV-related FUO.[3]
Classic FUO
Fever (>38.3° C or >100.9° F) for >3 weeks with no identified cause after 3 days of hospital evaluation or ≥3 outpatient visits
Nosocomial (health care-associated) FUO
Fever (>38.3° C or >100.9° F) in hospitalized patients receiving acute care and with no infection present or incubating on admission if the diagnosis remains uncertain after 3 days of appropriate evaluation
Neutropenic (immune-deficient) FUO
Fever (>38.3° C or >100.9° F) in patients with neutropenia (absolute neutrophil count ≤500 per mm3) or immunodeficiency if the diagnosis remains uncertain after 3 days of appropriate evaluation, including negative cultures after 48 hours
Fever (>38.3° C or >100.9° F) for >3 weeks in outpatients with confirmed HIV infection or >3 days in inpatients with confirmed HIV infection if the diagnosis remains uncertain after appropriate evaluation
References
- ↑ Wright WF, Auwaerter PG (2020). "Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma". Open Forum Infect Dis. 7 (5): ofaa132. doi:10.1093/ofid/ofaa132. PMC 7237822 Check
|pmc=value (help). PMID 32462043 Check|pmid=value (help). - ↑ Hayakawa K, Ramasamy B, Chandrasekar PH (2012). "Fever of unknown origin: an evidence-based review". Am J Med Sci. 344 (4): 307–16. doi:10.1097/MAJ.0b013e31824ae504. PMID 22475734.
- ↑ Durack, D. T.; Street, A. C. (1991). "Fever of unknown origin--reexamined and redefined". Current Clinical Topics in Infectious Diseases. 11: 35–51. ISSN 0195-3842. PMID 1651090.