Pyrexia of Unknown Origin (PUO) Flashcards
What is PUO?
Temperature greater than 38.3 for more than 3 weeks
When is the fever highest in PUO?
It is lowest in the morning
Highest in the evening
What is an exogenous fever caused by?
Endotoxin of gram negative bacteria
What is an endogenous fever?
Cytokines released from host cells in response to infection
What are the 3 types of PUO?
Nosocomial
Neutropenic
HIV-associated
What is nosocomial PUO?
Fever that develops in hospital and is undiagnosed after 3 days of investigation including 2 days of cultures
What is a neutropenic PUO?
Fever in a patient with neutrophil count of less than 500 cells/mm3 which is undiagnosed after 3 days of investigation
What is a HIV associated fever?
Fever in patient with HIV infection which has bene present and undiagnosed for more than 3 days in an inpatient and 4 days in an outpatient
What would you need to assess for in the history?
- Travel
- Occupation
- Hobby
- Sexual history
- Chemical exposure
- Familial disorders
What are the possible causes of PUO?
- Tuberculosis, HIV
- Abscess
- Malignancy
- Connective tissue disorder
What Malignancies could cause PUO?
Hodgkin’s lymphoma
Hypernephroma
Which connective tissue disorder could cause PUO?
Temporal arteritis
What is a fabricated fever?
A real but self-induced fever
How would a fabricated fever present?
- Normal pulse but febrile
* No elevated inflammatory markers
What are possible causes of a fabricated fever?
Self-injection
Self-injection with faecal organism
