Original article
Fever of unknown origin (FUO): report on 53 patients in a Dutch university hospital

https://doi.org/10.1016/0300-2977(95)00037-NGet rights and content

Abstract

Background and methods: Data on patients with fever of unknown origin (FUO) show that the problem of FUO differs, depending on place and time. To obtain a better insight into FUO in the Netherlands, we performed a retrospective study in our University Hospital.

Results: We studied 53 patients fulfilling FUO criteria. Infection was found in 11 patients (21%), neoplasms in 10 cases (19%), non-infectious inflammatory diseases in 12 patients (23%). In 16 patients (30%) no diagnosis could be made. In 12 patients fever subsided. In 4 patients fever persisted with a median follow-up of 14.5 years. In all 5 patients without directional clues no diagnosis could be made. In 21 patients (57%) the diagnosis was found by non-invasive methods, in 16 patients (43%) invasive methods were necessary. A median of 54 investigations were done in all patients.

Conclusions: The spectrum of FUO is changing. The proportion of patients in whom no diagnosis can be made is growing. The presence of directional clues seems to be an important issue, which other series often do not mention. Their importance should be studied in a larger, prospective study. The use of sophisticated diagnostic techniques seems to be extensive. Because very little is known about the diagnostic yield of many of those techniques, a prospective study on this aspect is needed.

References (16)

  • JW Smith

    Southwestern Internal Medicine Conference: fever of undetermined origin: not what it used to be

    Am J Med Sci

    (1986)
  • RG Petersdorf et al.

    Fever of unexplained origin: report on 100 cases

    Medicine

    (1961)
  • FJ Barbado et al.

    Fever of unknown origin: a survey on 133 patients

    J Med

    (1984)
  • EB Larson et al.

    Fever of undetermined origin: diagnosis and follow-up of 105 cases

    Medicine

    (1982)
  • P Howard et al.

    Fever of unknown origin: a prospective study of 100 patients

    Texas Med

    (1977)
  • R Gleckman et al.

    Fever of unknown origin: a view from the community hospital

    Am J Med Sci

    (1977)
  • WB Deal

    Fever of unknown origin: analysis of 34 patients

    Postgrad Med

    (1971)
  • A Hassan et al.

    Fever of undetermined origin in Cairo

    N Engl J Med

    (1974)
There are more references available in the full text version of this article.

Cited by (46)

  • Fever of unknown origin: An evidence-based review

    2012, American Journal of the Medical Sciences
    Citation Excerpt :

    An etiologic diagnosis can be made in more than 70% of cases of older patients with FUO (>65 years), whereas up to 51% of adults of all ages with FUO remain undiagnosed despite extensive workup.18,43,44 Because many of the causative diseases are treatable, an aggressive approach should be considered in investigating the etiology of FUO in older patients.45 The relatively frequent causes of FUO in patients older than 65 years are shown in Table 6.40,44,46

  • Paradox of fever of unknown origin

    2008, Medecine Nucleaire
  • Fever of unknown origin and cancer: A population-based study

    2005, Lancet Oncology
    Citation Excerpt :

    Moreover, fever of unknown origin was also associated with more-advanced disease and a poor outlook. Previous studies1,2,7,9,11,13,14 of patients with fever of unknown origin and subsequent cancer risk have included about 1200 people in total, and the recorded distribution of cancers was similar to that noted for the first year of follow-up in this study in that the most common malignant diseases were Hodgkin's lymphoma and non-Hodgkin lymphoma. Nearly all common cancers have been noted in previously published case studies of fever of unknown origin, although lymphoma and kidney cancer are most frequently reported.

View all citing articles on Scopus
View full text