Pyrexia of Unknown Origin Flashcards
1
Q
What is the definition of pyrexia of unknown origin?
A
A fever of above 38.3 on several occasions, persisting for over 3 weeks, despite intensive investigations for a week.
2
Q
What are the different types of pyrexia of unknown origin? Give examples of causes of these types
A
Classical
- Definition of PUO
- Caused by infection, malignancy, connective tissue disease
Healthcare associated
- PUO which develops over 24 hours after admission
- PE, c. diff, medical devices
Neutropaenic
- PUO plus a neutropaenia (<00)
- Chemotherapy, candidiasis, herpes, aspergillus
HIV-associated
- PUO and HIV +ve
- Kaposi’s
- Disseminated mycobacterium avium intracellulare
- PCP, CMV
3
Q
What is important to take in the assessment of PUO?
A
History:
- B symptoms
- Medications
- Foreign travel
- Contact/pets
Examinations:
- Full skin exam
- Eyes
- Musculoskeletal exam
Investigations:
- Stool culture
- Bloods: HIV/CMV/EBV
- Imaging: USS/CT
- RIPL: rare important pathogen (travel history)
- PET-CT
4
Q
What should you not forget in a case of PUO?
A
- Vasculitides (pANCA, cANCA, ANA etc.)
- Dip urine and MSC
- Familial diseases: FMF
- Fever in the returning traveller (see that lecture)
