Clinico-epidemiological profile of fever of unknown origin in an Egyptian setting: A hospital-based study (2009–2010)

Abstract

Introduction: Fever of unknown origin (FUO) is one of the most challenging diagnostic dilemmas in the field of infectious diseases and tropical medicine. Clinicians should use the frequency distribution of disorders causing FUO to guide their diagnostic approach in patients with prolonged, unexplained fevers meeting the definition of FUO. Methodology: The present study was undertaken to examine the etiologies, clinico-epidemiologic profile, and prognosis of classical FUO in patients reporting to the Alexandria Fever Hospital in Egypt. Records of 979 patients admitted to the fever hospital (from January 2009 to January 2010) and diagnosed as having FUO were examined carefully. FUO was defined as three outpatient visits or three days in the hospital without elucidation of cause of fever. Results: A total of 979 cases (57.0% males and 43.0% females), with ages ranging from 0.2 to 90 years, were investigated. The mean duration of fever before hospitalization was 31 ± 10 days. The etiology of FUO was delineated in 97% of cases, and only 3% remained undiagnosed. Diagnoses were grouped into five major categories. Infectious causes of FUO were strongly associated with better outcome (73.7% improved). Smoking, contact with animals or birds, drug addiction, and HIV seropositivity were important risk factors associated with infections. Conclusions: Infections are the most common cause of FUO, followed by collagen vascular diseases, in our region. A three-step diagnostic work-up approach is recommended to be applied in Egypt in order to improve the quality of medical service provided to FUO patients.

Fever of unknown origin (FUO) on a land on cross‐roads between Asia and Europa; a multicentre study from Turkey

“…In a study from Japan with high rate of non‐infectious aetiology, 4 of 30 (13.3%) patients with FUO of unknown cause died within 6 months in follow‐up 32 . In a study from Egypt with high rate of infectious aetiology, the mortality rate was 2.2% 35 . Patients showed good outcome in our study, with only one mortal case with undiagnosed FUO aetiology.…”

Highlighting the Role of Infections in the Etiology of Fever of Unknown Origin Pointing out Toxoplasmosis; in Port Said Governorate

“…However, it is possible that this pronounced immune reactivity makes women more prone to developing autoimmune diseases [18]. Contact with animals or birds is important risk factors for acquiring infections that may cause FUO [19].…”

Fever of Unknown Origin (FUO): towards uniform definitions and classification system

“…The current absence of a consensus on which definition for FUO is the most adequate permits many studies to use the definitions from 1961 (34)(35)(36)(37)(38) and 1991 (12,34,39,40), which makes comparisons among different studies challenging. For example, one study included 979 patients with FUO according to the definition from 1991, and only 555 of them met the criteria for FUO according to the definition from 1961 (41). In another study, only 59 patients out of 80 with FUO according to the definition from 1991 fulfilled the criteria for FUO according to the 1961 definition (34).…”