PUO

Question 1

Definition of PUO?

Answer 1

Persistent fever >38.3 for >3 weeks for which there is no diagnosis made despite extensive investigations.

Question 2

What are some of the common causes of PUO? (5)

Answer 2

1. Malignancy (haematological, solid, mets)
2. Connective Tissue Diseases (RA, SLE, Still’s, Vasculitis)
3. Rarer infections

• Bacteria in unusual locations - TB, abscess, endocarditis, pericarditis, OM, discitis, epidural abscess.
• Rare bacteria: chlamydia, rickettsia, leptospira, brucella, atypical mycobacterial, Coxiella (Q-fever)
• Viral: HIV, CMV, EBV
• Parasitic: malaria, amoebiasis, toxoplasma

4. Inflammatory conditions
   * IBD, Granulomatous disease (sarcoid), pericarditis, multiple PEs
5. Drug-induced: ABx, NSAIDs…etc.

Question 3

What are the key questions you must ask in PUO patients?

Answer 3

1. Travel
2. Sexual
3. Occupational/hobbies
4. Domestic animals