Pyrexia of Unknown Origin Flashcards
1
Q
What is the definition of PUO?
A
- A temperature of > 38.3C
- No diagnosis made after 3 outpatient visits or 3 days in hospital or 1 week of outpatient investigation
2
Q
What are the major disease categories which can present with a PUO?
A
- Neutropenic PUO (neutrophils < 500)
- HIV-associated PUO
- Nosocomial PUO (develops in hospital)
3
Q
What are the important aspects of taking a history from a PUO patient?
A
- Recent travel
- Occupation and hobbies (exposure to allergens)
- Family history and age on onset (familial fevers)
- PMH
- DH
4
Q
What are the important aspects of examining a PUO patient?
A
- Be thorough and often useful to repeat examination
- Skin for rashes
- Eyes
- Oral cavity
- Nails
- Lymph nodes
5
Q
What investigations are important for PUO patients?
A
- CXR
- Urinalysis and urine microscopy
- FBC
- CRP and ESR
- Blood cultures during periods of fever
- U&E’s, creatinine, LFT’s
6
Q
What are some of the modern imaging techniques available for use in investigating PUO?
A
- CT PET
- USS
