TY - JOUR
T1 - Fever of unknown origin
T2 - A 12-year case series in Colombia
AU - Vásquez-Jiménez, Juan Manuel
AU - Mackenzie, Sebastián
AU - Pulido-Arenas, Jorge
AU - Bernal-Macías, Santiago
AU - Garzon, Javier Ricardo
AU - Ordóñez, Ivonne Tatiana
AU - Correa, Néstor Fabián
AU - Muñoz, Oscar
N1 - Copyright (c) 2024 Juan Manuel Vásquez-Jiménez, Sebastián Mackenzie, Jorge Pulido-Arenas, Santiago Bernal-Macías, Javier Ricardo Garzon, Ivonne Tatiana Ordóñez, Néstor Fabián Correa, Oscar Muñoz.
PY - 2024/6/30
Y1 - 2024/6/30
N2 - Background: Fever of unknown origin (FUO) is a diagnostic challenge with highly heterogeneous causes. Its etiology can change according to the studied regions, and the chance of reaching a diagnosis depends on available resources. The aim of this study is to describe the clinical characteristics, etiology and the usefulness of diagnostic aids in cases of FUO managed over 12 years in a Colombian reference center. Methodology: Single-institution retrospective case series. All cases of FUO between 2006 and 2017 were identified with the help of an electronic medical record search software. Cases of adults with fever for more than three weeks who remained undiagnosed after three days of hospitalization are described. Results: Of 1,009 cases evaluated, 112 cases met the inclusion criteria (median age 43 years, 66% men). The etiologies identified were infectious (31.2%), inflammatory (20.5%), neoplastic (14.3%), and miscellaneous (2.7%) diseases. 31.2% remained without etiological diagnosis. The most frequent conditions were tuberculosis (17%), Hodgkin's lymphoma (7.1%), systemic lupus erythematosus (6.3%), disseminated histoplasmosis, and adult Still's disease. Contrast tomography and biopsies were the studies that most frequently supported or confirmed the final diagnosis. Conclusions: This series of contemporary Latin American cases suggests that the categories of FUO etiologies are similar to those reported in studies from developed countries, with tuberculosis being the most frequent cause in our setting. Our results highlight the importance of tomography-guided invasive studies in the diagnostic approach to FUO.
AB - Background: Fever of unknown origin (FUO) is a diagnostic challenge with highly heterogeneous causes. Its etiology can change according to the studied regions, and the chance of reaching a diagnosis depends on available resources. The aim of this study is to describe the clinical characteristics, etiology and the usefulness of diagnostic aids in cases of FUO managed over 12 years in a Colombian reference center. Methodology: Single-institution retrospective case series. All cases of FUO between 2006 and 2017 were identified with the help of an electronic medical record search software. Cases of adults with fever for more than three weeks who remained undiagnosed after three days of hospitalization are described. Results: Of 1,009 cases evaluated, 112 cases met the inclusion criteria (median age 43 years, 66% men). The etiologies identified were infectious (31.2%), inflammatory (20.5%), neoplastic (14.3%), and miscellaneous (2.7%) diseases. 31.2% remained without etiological diagnosis. The most frequent conditions were tuberculosis (17%), Hodgkin's lymphoma (7.1%), systemic lupus erythematosus (6.3%), disseminated histoplasmosis, and adult Still's disease. Contrast tomography and biopsies were the studies that most frequently supported or confirmed the final diagnosis. Conclusions: This series of contemporary Latin American cases suggests that the categories of FUO etiologies are similar to those reported in studies from developed countries, with tuberculosis being the most frequent cause in our setting. Our results highlight the importance of tomography-guided invasive studies in the diagnostic approach to FUO.
KW - biopsy
KW - Fever
KW - fever of unknown origin
KW - lymphoma
KW - pyrexia
KW - tuberculosis
KW - Humans
KW - Middle Aged
KW - Male
KW - Fever of Unknown Origin/etiology
KW - Colombia/epidemiology
KW - Young Adult
KW - Adolescent
KW - Adult
KW - Female
KW - Retrospective Studies
KW - Aged
UR - http://www.scopus.com/inward/record.url?scp=85198241956&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/94f58b57-f5e7-3d75-a010-448a3e422615/
U2 - 10.3855/jidc.18192
DO - 10.3855/jidc.18192
M3 - Article
C2 - 38990985
AN - SCOPUS:85198241956
SN - 2036-6590
VL - 18
SP - 880
EP - 886
JO - Journal of Infection in Developing Countries
JF - Journal of Infection in Developing Countries
IS - 6
ER -