Fever of Unknown Origin

Marcus, Esther‐Lee; Dijk, J. M. Van

doi:10.1111/j.1532-5415.1991.tb03611.x

Cited by 5 publications

(3 citation statements)

References 3 publications

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“…Nevertheless, factitious fever may occur in older patients 29 . Potin et al described an 80‐year‐old man who tampered with the thermometer, and Marcus et al reported factitious fever in a 79‐year‐old woman, her motive being not to be discharged home 30,31 …”

Section: Discussionmentioning

confidence: 99%

Fever of Unknown Origin in Elderly Patients

Knockaert

Vanneste

Bobbaers

1993

J American Geriatrics Society

160

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Objective: To describe the spectrum of diseases that may give rise to fever of unknown origin in elderly patients and to delineate the diagnostic approach in these patients. Design: Subgroup analysis of a prospectively collected case series followed more than 2 years. Setting: General Internal Medicine Service based at University hospital, Leuven, Belgium. Patients: Forty‐seven consecutive patients, older than 65 years, meeting the classic criteria of fever of unknown origin. Measurements: The final diagnosis established and the clinical value of diagnostic procedures. Results: Infections, tumors and multisystem diseases (encompassing rheumatic diseases, connective tissue disorders, vasculitis including temporal arteritis, polymyalgia rheumatica, and sarcoidosis) were found in 12 (25%), six (12%) and 15 patients (31%), respectively. Drug‐related fever was the cause in three patients (6%), miscellaneous conditions were found in five patients (10%), and six patients (12%) remained undiagnosed. Microbiologic investigations were diagnostic in eight cases (16%), serologic tests yielded one diagnosis, immunologic investigations had a diagnostic value in four cases, standard X‐rays yielded a diagnostic contribution in 10 cases, ultrasonography and computed tomography were diagnostic in 11 cases, Gallium scintigraphy had a diagnostic contribution in 17 cases, and biopsies yielded the final diagnosis in 18 cases. Conclusions: Multisystem diseases emerged as the most frequent cause of fever of unknown origin in the elderly, and temporal arteritis was the most frequent specific diagnosis. Infections, particularly tuberculosis, remain an important group. The percentage of tumors was higher in our elderly patients than in the younger ones but still clearly lower than in other recent series of FUO in adults. The number of undiagnosed cases was significantly lower in elderly patients than in younger individuals (P ≤ 0.01). The investigation of elderly patients with FUO should encompass routine temporal artery biopsy and extensive search for tuberculosis if the classic tests such as blood count, chemistry, urinalysis, cultures, chest X‐rays, and abdominal ultrasonography do not yield any clue. Gallium scintigraphy should be considered as the next step and not as a last‐resort procedure.

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Section: Discussionmentioning

confidence: 99%

Fever of Unknown Origin in Elderly Patients

Knockaert

Vanneste

Bobbaers

1993

J American Geriatrics Society

160

View full text Add to dashboard Cite

show abstract

“…The causes of FUO in the elderly are rarely benign or selflimited; almost always, an elderly patient with FUO will be found to have a serious illness as the cause of the fever. ':" Factitious and fraudulent causes of FUO are exceedingly rare in the elderly.7, 8 We present the cases of two elderly men with FUO, which was ultimately shown to be caused by lymphoma. Both had back pain with vertebral compression fractures relate a to the neoplasms, and initially both were presumed to have these fractures secondary to osteoporosis.…”

mentioning

confidence: 99%

“…The causes of FUO in the elderly are rarely benign or self‐limited; almost always, an elderly patient with FUO will be found to have a serious illness as the cause of the fever 1–6 . Factitious and fraudulent causes of FUO are exceedingly rare in the elderly 7, 8 …”

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confidence: 99%