Skip to main content
Don?T Ignore Elevated Body Temperature
Internal Medicine

Don?T Ignore Elevated Body Temperature

Dr. Mugdha Tapdiya Aug 11, 2014
Fever of Unknown Origin (FUO) refers to a condition in which the patient has an elevated body temperature, however, despite investigations by a physician no explanation can be found. If the cause is found by eliminating all possibilities, then only one explanation remains and it is considered as the correct one.  Criteria for diagnosis • Fever higher than 38.3°C (101°F) on several occasions • Persisting without diagnosis for at least three weeks • At least one week’s investigation in hospital A new definition, which includes the outpatient setting (which reflects current medical practice) is broader, stipulating: • Three outpatient visits or • Three days in the hospital without elucidation of a cause or • One week of 'intelligent and invasive' ambulatory investigation. Classic FUO Studies show there are five categories of conditions: • Infection (e.g. abscesses, endocarditis, tuberculosis, and complicated urinary tract infections) • Neoplasms/ malignancies / cancers (e.g. lymphomas, leukaemia, tumours) • Connective tissue disease (e.g. temporal arteries and polymyalgia, rheumatica, still disease, systematic lupus erythematosus and  rheumatoid arthritis) • Miscellaneous disorders (e.g. alcoholic hepatitis, granulomatous conditions) and undiagnosed conditions At present less frequent causes of FUO are indicated in three cases. 1. Nosocomial: Nosocomial FUO refers to fever in patients who have been admitted to hospital for at least 24 hours. This is commonly related to hospital associated factors such as surgery, use of urinary catheter, intra-vascular devices (i.e. drip, pulmonary artery catheter), drugs (antibiotics induced colitis and drug fever), immobilisation (bed sores). 2. Immune deficient: Immuno-deficiency can be seen in patients receiving chemotherapy or in hematologic malignancies. Fever is associated with Neutropenia (Neutrophil<500/ul) or impaired cell-mediated immunity. Infection is the most common cause. 3. Human Immuno-deficiency Virus (HIV) associated: HIV-infected patients are a subgroup of the immunodeficient FUO and frequently have fever. The primary phase shows fever since it has a mononucleosis-like illness. In advanced stages of infection, fever mostly is the result of a superimposed infection.  Causes Extra pulmonary tuberculosis is the most frequent cause of FUO. Drug induced fever, as sole symptom of an adverse reaction to medication, should always be considered. Lymphomas are the most common cause of FUO in adults. Thromboembolic disease (i.e. pulmonary embolism, deep venous thrombosis) occasionally shows fever. Although infrequent, its potentially lethal consequences warrant evaluation of this cause. Endocarditis (infection of heart valves), although uncommon, is another important thing to consider. Therapy Unless the patient is acutely ill, no therapy should be started before the cause has been found. An exception is made for neutropenic patients where delay could lead to serious complications. After blood cultures are taken, this condition is aggressively treated with broad-spectrum antibiotics. Antibiotics are adjusted according to the results of the cultures taken. HIV-infected persons with fever and hypoxia (low oxygen concentration), will be started on medication.  

श्रेणियाँ

सभी साफ करें

Meet the doctor

Dr. Mugdha Tapdiya
Dr. Mugdha Tapdiya
ADDITIONAL DIRECTOR INTERNAL MEDICINE | Fortis Vasant Kunj
  • Internal Medicine | General Physician
  • Date 26 Years
  • INR 1300
Enjoy A Healthy Monsoon
Internal Medicine

Enjoy A Healthy Monsoon

Dr. J. M. S. Kalra Mar 18, 2023
Zoonosis In Modern Medicine
Internal Medicine

Zoonosis In Modern Medicine

Zoonosis In Modern Medicine Oct 16, 2019
Is Paracetamol A Cure To All Kind of Fevers?
Internal Medicine

Is Paracetamol A Cure To All Kind of Fevers?

Is Paracetamol A Cure To All Kind of Fevers? Oct 12, 2017
Public Advisory On Dengue And Chikungunya
Internal Medicine

Public Advisory On Dengue And Chikungunya

Public Advisory On Dengue And Chikungunya Sep 20, 2016
Case of Guillain Barre (Gb) Syndrome
Internal Medicine

Case of Guillain Barre (Gb) Syndrome

Dr. Paritosh Baghel Sep 12, 2016
Tips To Avoid Lifestyle Diseases
Internal Medicine

Tips To Avoid Lifestyle Diseases

Dr. Raman Abhi Sep 25, 2014
Tackling Jaundice
Internal Medicine

Tackling Jaundice

Dr. Damanjit Singh Chadha Jul 11, 2014
Have A Healthy Monsoon!
Internal Medicine

Have A Healthy Monsoon!

Have A Healthy Monsoon! Jul 07, 2014
blog
Internal Medicine

Stay Healthy

Dr. Rajinder Yadav Jun 16, 2014
blog
Internal Medicine

Beat The Heatstroke

Dr. Damanjit Singh Chadha Jun 11, 2014
barqut

Keep track of your appointments, get updates & more!

app-store google-play
Request callback