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Harrison's Principles of Internal Medicine, 18e
| Part 2. Cardinal Manifestations and Presentation of Diseases > Section 2. Alterations in Body Temperature > |
Chapter 18. Fever of Unknown Origin
Sections: Fever of Unknown Origin: Introduction, Acknowledgments, Further Readings.
Topics Discussed: fever of unknown origin.
Excerpt:"Fever of unknown origin (FUO) was defined by Petersdorf and Beeson in 1961 as (1) temperatures of >38.3°C (>101°F) on several occasions; (2) a duration of fever of >3 weeks; and (3) failure to reach a diagnosis despite 1 week of inpatient investigation. While this classification has stood for more than 30 years, Durack and Street have proposed a revised system for classification of FUO that better accounts for nonendemic and emerging diseases, improved diagnostic technologies, and adverse reactions to new therapeutic interventions. This updated classification includes (1) classic FUO, (2) nosocomial FUO, (3) neutropenic FUO, and (4) FUO associated with HIV infection.A stepwise flow chart depicting the diagnostic workup and therapeutic management of FUO is provided in Fig. 18-1. In this flow chart, reference is made to "potentially diagnostic clues," as outlined by de Kleijn and colleagues; these clues may be key findings in the history (e.g., travel), localizing signs, or key symptoms. Certain specific diagnostic maneuvers become critical in dealing with prolonged fevers. If factitious fever is suspected, temperature-taking should be supervised, and simultaneous urine and body temperatures should be measured. Thick blood smears should..."
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