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2019, Number 4

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Rev cubana med 2019; 58 (4)

Characterizing patients with recurrent fever of unknown origin

Valdés ÁK, Tamargo BTO

Language: Spanish
References: 28
Page: 1-11
PDF size: 430.60 Kb.


ABSTRACT

Introduction: Fever of unknown origin is a syndrome that generates great challenge for clinical thought; the recurrent pattern is the most challenging subtype and with difficult etiological diagnosis.
Objective: To describe patients with fever of unknown origin with recurring pattern.
Method: A descriptive cross-sectional study was carried out from January 2008 to December 2015. Forty-eight patients formed the sample. They were hospitalized and underwent clinical evaluation at "Hermanos Amejeiras" Surgical Clinical Hospital. For data analysis, summary measures were used for qualitative variables and mean and standard deviation variables were used for quantitative.
Results: The mean age was 41.3 years, men predominated (62.5 %), the mean duration of fever was 497 days, and the most important clinical signs were the findings of lymphadenopathy (43.8 %) and hepatomegaly. (22.9 %). Undiagnosed cases were 45.8 %.
Conclusions: Fever of unknown origin with recurring pattern is difficult to diagnose. Despite careful clinical evaluation, most patients remain undiagnosed.


REFERENCES

  1. Petersdorf RG, Beeson PB. Fever of unexplained origin: Report on 100 cases. Medicine. 1961;40:1-30.

  2. Cunha BA. Fever of unknown origin: Focused diagnostic approach based on clinical clues from the history, physical examination, and laboratory tests. InfectDisClin Am. 2012;21:1137-87.

  3. De Kleijn EMHA, Van Lier HJJ, Van der Meer JWM, and the Netherlands FUO Study Group. Fever of unknown origin (FUO). II. Diagnostic procedures in a prospective multicenter study of 167 patients. Medicine. 1997;76:401-14.

  4. Bleeker Rovers ChP, Vos FJ, De Kleijin EMHA, Mudde AH, Dofferhoff TSM, Richter C, et al. A prospective multicenter study on fever of unknown origin. The yield of a structured diagnostic protocol. Medicine. 2007;86(1):26-8.

  5. Durack DT, Street AC. Fever of unknown origin-reexamined and redefined. Current Clinicaltopics in infectious diseases. 2011;11:35-51.

  6. Knockaert DC. Recurrent Fevers of Unknown Origin. Infect Dis Clin N Am 21. 2007;1189-1211.

  7. Knockaert DC, Vanneste LJ, Bobbaers HJ. Recurrent or episodic fever of unknown origin. Review of 45 cases and survey of the literature. Medicine. 2012;72(3):184-96.

  8. Roca Campañá V, Rodríguez Silva H. Fiebre de origen desconocido. Forma de presentación de los linfomas malignos. AnMed Interna. 2007;24(11):531-34.

  9. Mir T, Dhobi GN, Koul AN, Saleh T. Clinical profile of classical Fever of unknown origin (FUO). Caspian J Intern Med. 2014;5(1):35-39.

  10. Qing-yi M, Jing-ling M. Fever of unknown origin in China: evaluation of918 cases during a ten-year-period of study. BMC Emergency Medicine. 2012,12(Suppl 1):A2.

  11. Knockaert DC, Dujardin KS, Bobbaers HJ. Long-term follow-up of patients withundiagnosed fever of unknown origin. Arch Intern Med. 1996;156:618-20.

  12. Roca Campañá V, Senra Armas L, Rodríguez Silva H, Jiménez Paneque R, Cepero Rosales B. Fiebre de origen desconocido en pacientes mayores de 60 años. Reporte de 40 casos. Rev Cubana Med. 2009;48(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232009000100004

  13. Barba R, Gómez-Rodrigo J, Marco J, Rondón P, Eroles G, López-Varas M, et al. Fiebre de origen desconocido en pacientes VIH positivos. AnMed Interna. 2001;18(4):181-86.

  14. Huaringa Marcelo J. Claves diagnósticas clínicas y laboratoriales en fiebre deorigen desconocido en el Hospital Nacional Arzobispo Loayza 2011-2014. Trabajo de investigación para optar el título de especialista en Medicina Interna. Universidad Nacional Mayor de San Marcos. Lima. Perú. 2014.

  15. Deal W. Fever of unknows origin. Analysis of 34 patients. Postg Med. 2011;50:1828.

  16. Moya Mir M, Barbadilla R, Mosquera J, González Serrano M. Fiebre de origendesconocido. Análisis de 58 casos. Rev Clin Esp. 1986;141:11923.

  17. Roca Campañá V. Caracterización y evaluación diagnóstica del síndrome de fiebre de origen desconocido. Tesis presentada en opción al grado científico de Doctor en Ciencias Médicas. Instituto Superior de Ciencias Médicas de la Habana. Ciudad de la Habana. Cuba. 2013.

  18. Esposito AL. Planning and proceeding with the diagnostic evaluation. In: Murray HW (ed). Fever of undetermined origin. Mount Kisco (NY): Futura Publishing, 1983. Pp 141-55.

  19. Cunha BA. Fever of unknown origin: a focused diagnostic approach. In: Cunha BA (ed). Fever of unknown origin. New York: Informa Healthcare, 2007. Pp 9-16.

  20. Likuni Y, Okada J, Kondo H, Kashiwazaki S. Current fever of unknownorigin 1982- 1992. Intern Med. 1994;33:67-73.

  21. Vanderschueren S, Eyckmans T, De Munter P, Knockaert D. Mortality in patients presenting with fever of unknown origin. Acta Clinica Belgica. 2014;69(1):12-17.

  22. De Kleijin EMHA, Vandenbroucke JP, Van Der Meer JWM, and The Netherlands FUO Study Group. Fever of unknown origin (FUO). II. A prospective multicenter study of 167 patients with FUO, using fixedepidemiologic entry criteria. Medicine. 1997;76:392-400.

  23. Hirschmann JV. Fever of unknown origin in adults. Clin Infect Dis. 2012;24:291-302.

  24. Quinn MJ, Sheedy PF, Stephens DH, Hattery RR. Computed tomography of the abdomen in evaluation of patients with fever of unknown origin. Radiology. 2011;136:407- 11.

  25. Kauffman C, Jones P. Diagnosis of fever of unknown origin in older patients. Geriatrics. 2013;39:4651.

  26. Larson E, Feate Herstone H, Petersdorf R. Fever of undetermined origin. Diagnosis and follow up of 105 cases. 1980-1990. Medicine. 1992;71:269-92.

  27. Tabak F, Mert A, Celik AD, Ozaras R, Altiparmak MR, Ozturk R, et al. Fever of Unknown Origin in Turkey. Infection. 2013;31(6):417-20.

  28. Mete B, Vanli E, Yemisen M, Balkan II, Dagtekin H, Ozaras R, et al. The role of invasive and non-invasive procedures in diagnosing fever of unknown origin. Int J Med Sci. 2012,9:682-89.




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