ICR Fever

Question 1

What’s the Harrison’s definition of Fever of Unknown Origin (FUO)?

Answer 1

Not finding the source of the fever after:
1) 3 outpatient visits or
2) 3 days in hospital
or
3) 1 weeks of “intelligent and invasive” ambulatory investigation.

Question 2

Common categories of FUO in travelers?

Answer 2

1. Parasitic organisms
2. Enteric organisms
3. Respiratory pathogens
4. Systemic viral illnesses/Serious Bacterial Infection (SBI)

Question 3

Adopted children from China are likely to have:

Answer 3

Measles. Just in case this shows up on the faculty. This is uncommon in US, common in the rest of the world.

Question 4

Fever = ___________ not infection

Answer 4

Inflammation

Question 5

3 Big categories of inflammation inducing pathways:

Answer 5

1. Infection
2. Cancer
3. Immune disease

There is a lot of overlap between these categories

Question 6

What can the duration of sx tell you about the type of FUO a pt has?

Answer 6

1. Infection: mostly rapid onset/resolution, or you die from it. (some expceptions with chronic inflammation)
2. Cancer: “declares” itself w/in weeks
3. Immune/Rheumatologic: long histories, w/ waxing and waning for months to years

Question 7

What’s the most important qualifier of an FUO?

Answer 7

Is the patient sick/ill or not sick

Question 8

Lab evaluation tiers:

Answer 8

1. Inflammatory markers, tissue/organ injury markers
2. Specific serologies, specific organ system evaluations
3. 3d imaging (CT, MRI, US)