-
Temperature that lasts for >3 weeks with no obvious source despite appropriate investigation
Fever of unknown origin
-
4 categories of potential etiology of FUO
- Classic
- Nosocomial
- Immune Deficient
- HIV-related
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4 Subgroups of the DD of FUO
- Infxns
- Malginancies
- Autoimmune conditions
- Miscellaneous
-
As fever duration increases
likelihood of infectious etiology decreases
-
Most common autoimmune diseases that cause FUO
- Temporal arteritis (#1 cause in elderly)
- Adult Still's
Reflects better serologic dx of other rheum diseases
-
Still's Major criteria
- Fever > 39C for >1wk
- Arthralgia > 2 wks
- Typical rash
- WBC >10 w/ > 80% segs
-
Still's Minor Criteria
- Sore throat
- LAN +/- splenomegaly
- Hepatic abnormalities
- Negative RF and ANA
-
Still's Diagnosis
- 5+ criteria
- 2+ major criteria
- Exclude: Infxn, malignancy, other rheum diseases
-
ESR >100 consider
- Malignancy (lymphoma, myeloma, mets)
- Infxns (endocarditis)
- Collagen-vascular: TA, RA
-
Neutropenic fever
- Bacteremia <7days
- Fungal infxns >7days
Fever usually abates with return of neutrophils
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