Fever of Unknown Origin in a Portuguese Tertiary Hospital: A Cohort Study

• Main Author: Ferreira,Mafalda
• Publication Date: 2022
• Other Authors: Coutinho,lolanda Alen, Lavrador,Mariana, Duarte,Odete, Espert,Helder, Carvalho,Armando
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2022000200058
• topic: Fever of Unknown Originldiagnosis; Fever of Unknown Origin/etiology.

Abstract lntroduction: Fever of unknown origin (FUO) remains a major diagnostic challenge, despite advances in the medical field. lt can be caused by a broad spectrum of diseases with very different prognostic outcomes. Constant re-evaluation of clínical data is essential considering the dynamic changes in disease patterns. We aim to understand which clínical approach is most commonly used and recognize our local epidemiology in arder to improve the diagnostic approach to these patients. Methods: We performed a retrospective study in an internal medicine department of a public tertiary hospital. Clínical records of all patients admitted during 2016 and 2017 were consulted; data from patients that fulfilled FUO criteria were collected. Results: A total of 55 FUO patients were identified (0.6% of all admissions). lnfections were the most frequent cause (n = 23; 41.8%) fol/owed by non-infectious inflammatory diseases (n = 12; 21.8%), malignancies (n = 8; 14.5%) and miscella­neous group (n = 3; 5.5%). However, in 9 cases (16.4%) the etiology remained unknown. The most common disease causing FUO was Q fever, followed by infective bacterial endocarditis and abscesses in different locations. Microbiological study of urine and blood was performed in ail patients, while serological tests showed wider variability. The use of 1 BF-fluorodesoxyglucose positron emission tomography (1 BF-FDG­PET) in 11 (20.0%) cases stands out. Conclusion: FUO etiologies in our cohort were comparable to other published studies despite the smaller sample. lnfections were the most frequent cause identified. Though a significant number of cases remained unknown, it carried a good prognosis.