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The osler medical handbook -john hopkin

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Section VIII – Infectious DiseasesSection Editors:Christopher Hoffmann, MD, MPH Nicola Zetola, MDChapter 53 – Fever of Unknown OriginScott Kim, MD Rachel Damico, MD, PhD Paul Auwaerter, MDFAST FACTS ▪ The contemporary understanding of fever of unknown origin (FUO) is derived from Petersdorf and Beeson's 1961 characterization of FUO. A stringent definition of FUO is composed of the following criteria[1]: temperature higher than 38.3° C measured on several occasions, 3-week duration (to exclude self-limiting fevers), negative blood cultures, no apparent explanation, and three outpatient visits or three hospital days. ▪ Infections, malignancies, and noninfectious inflammatory diseases account for the majority of cases of FUO. ▪ In patients older than 65 years, temporal arteritis should be considered early in any evaluation. ▪ Patients with FUO who remain undiagnosed after exhaustive study usually have a favorable prognosis. In one study, in a cohort of 61 patients with FUO discharged without diagnosis, the 5-year mortality rate was only 3.2%.[2]…