Fever of Unknown Origin Flashcards
Define ‘fever’ and ‘febrile illness’
Temperature above 38°C
Define pyrexia/fever of unknown origin
Temperature above or = 38.1°C
No diagnosis after 3 weeks or 1 week of hospital tests
Define ‘acute undifferentiated febrile illness’
Temperature above or = 38.0°C with no organ focus and < 2 weeks duration
Which ‘occult infections’ can be responsible for causing a fever of unknown origin?
Endocarditis
Liver abscess
Biliary infections
UTI
LRTI
What can a low temperature be indicative of especially in the elderly?
Sepsis
Name 3 protozoa that can cause fever of unknown origin
Malaria
Leishmaniasis
Trypanosomiasis
Name 4 bacterial infections that can cause fever of unknown origin
Enteric fever (salmonella species)
Tuberculosis
Q fever
Brucelossis
Name 2 spirochaetes that can cause fever of unknown origin
Leptospirosis
Relapsing fever
Name 2 rickettsia that cause fever of unknown origin
Typhus
Bartonelllosis
Name some arboviruses that cause fever of unknown origin
Dengue
Chikungunya
Sand fly fever
Zika
Japanese encephalitis
Yellow fever
West nile fever
Name some non-infectious causes of fever of unknown origin
Malignancy
Autoimmune disease
Heat illness
Name some other viruses that can cause of fever unknown origin
HIV
CMV
Viral hepatitis
EBV
Hantavirus
What information needs to be taken regarding a person with fever of unknown origin?
- Immunocompromise?
- Recent travel?- where/when
- Activities
- Accommodation/transport
- Food/water
- Insects/animal contact- bites/stings
- Sexual contacts and drugs- needles/blood products/protection used?
- Freshwater exposure and bare skin contact with the ground?
- Precautions and prophylaxis taken?
What laboratory investigations should be conducted in fever of unknown origin?
Urinalysis: ?haematuria/proteinuria/WBCs
FBC: Hb/neutrophils/lymphocytes/platelets
U&Es:?AKI
LFTs:?hepatitis
CRP:?acute bacterial infection
ESR:?chronic bacterial infection/inflammation
Lactate:?tissue hypoperfusion/sepsis
Autoantibodies:?autoimmune disease
Which microbiology investigations should be carried out in fever of unknown origin?
Blood cultures (+/- mycobacterial cultures)
Urine MC&S
Stool MC&S
Malaria blood films and antigen tests
Serology tests (for viral/rare/tropical infections)
PCR tests: esp for viral and rare infections
What does this CT Abdo show?
Liver abscess
