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Pyrexia of unknown origin

MedGen UID:
42012
•Concept ID:
C0015970
•
Sign or Symptom
Synonyms: Fever of Unknown Origin; Unknown Origin Fever; Unknown Origin Fevers
SNOMED CT: PUO - Pyrexia of unknown origin (7520000); Fever of unknown origin (7520000); F.U.O. (7520000); Pyrexia of unknown origin (7520000)

Definition

A febrile process with an etiology that is not apparent or yet determined. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPyrexia of unknown origin

Professional guidelines

PubMed

Fever of Unknown Origin (FUO) - A Call for New Research Standards and Updated Clinical Management.
Wright WF, Mulders-Manders CM, Auwaerter PG, Bleeker-Rovers CP
Am J Med 2022 Feb;135(2):173-178. Epub 2021 Aug 24 doi: 10.1016/j.amjmed.2021.07.038. PMID: 34437835
Clinical presentations, microbiology and management outcomes of culture-proven endogenous endophthalmitis in India.
Dave VP, Pathengay A, Panchal B, Jindal A, Datta A, Sharma S, Pappuru RR, Joseph J, Jalali S, Das T
Indian J Ophthalmol 2020 May;68(5):834-839. doi: 10.4103/ijo.IJO_1091_19. PMID: 32317456Free PMC Article
Pyrexia of unknown origin: causes, investigation and management.
Beresford RW, Gosbell IB
Intern Med J 2016 Sep;46(9):1011-6. doi: 10.1111/imj.13180. PMID: 27633467

Recent clinical studies

Etiology

Pyrexia of unknown origin and its aetiology in Pakistan.
Akhtar W, Awan S, Ishaq U, Malik A, Malik J, Zaidi SMJ
Trop Doct 2022 Oct;52(4):567-571. Epub 2022 Jul 14 doi: 10.1177/00494755221096902. PMID: 35833343
Prospective Studies Comparing Structured vs Nonstructured Diagnostic Protocol Evaluations Among Patients With Fever of Unknown Origin: A Systematic Review and Meta-analysis.
Wright WF, Betz JF, Auwaerter PG
JAMA Netw Open 2022 Jun 1;5(6):e2215000. doi: 10.1001/jamanetworkopen.2022.15000. PMID: 35653154Free PMC Article
Aetiology of pyrexia of unknown origin in north India.
Pannu AK, Golla R, Kumari S, Suri V, Gupta P, Kumar R
Trop Doct 2021 Jan;51(1):34-40. Epub 2020 Aug 17 doi: 10.1177/0049475520947907. PMID: 32807027
Pyrexia of unknown origin.
Fernandez C, Beeching NJ
Clin Med (Lond) 2018 Mar;18(2):170-174. doi: 10.7861/clinmedicine.18-2-170. PMID: 29626024Free PMC Article
Investigating and managing pyrexia of unknown origin in adults.
Varghese GM, Trowbridge P, Doherty T
BMJ 2010;341:C5470. doi: 10.1136/bmj.c5470. PMID: 22312655

Diagnosis

Prospective Studies Comparing Structured vs Nonstructured Diagnostic Protocol Evaluations Among Patients With Fever of Unknown Origin: A Systematic Review and Meta-analysis.
Wright WF, Betz JF, Auwaerter PG
JAMA Netw Open 2022 Jun 1;5(6):e2215000. doi: 10.1001/jamanetworkopen.2022.15000. PMID: 35653154Free PMC Article
Fever of Unknown Origin (FUO) - A Call for New Research Standards and Updated Clinical Management.
Wright WF, Mulders-Manders CM, Auwaerter PG, Bleeker-Rovers CP
Am J Med 2022 Feb;135(2):173-178. Epub 2021 Aug 24 doi: 10.1016/j.amjmed.2021.07.038. PMID: 34437835
Recent advances in the diagnosis of leptospirosis.
Verma V, Goyal M, Kala D, Gupta S, Kumar D, Kaushal A
Front Biosci (Landmark Ed) 2020 Mar 1;25(9):1655-1681. doi: 10.2741/4872. PMID: 32114449
Pyrexia of unknown origin.
Fernandez C, Beeching NJ
Clin Med (Lond) 2018 Mar;18(2):170-174. doi: 10.7861/clinmedicine.18-2-170. PMID: 29626024Free PMC Article
Pyrexia of unknown origin: causes, investigation and management.
Beresford RW, Gosbell IB
Intern Med J 2016 Sep;46(9):1011-6. doi: 10.1111/imj.13180. PMID: 27633467

Therapy

Prospective Studies Comparing Structured vs Nonstructured Diagnostic Protocol Evaluations Among Patients With Fever of Unknown Origin: A Systematic Review and Meta-analysis.
Wright WF, Betz JF, Auwaerter PG
JAMA Netw Open 2022 Jun 1;5(6):e2215000. doi: 10.1001/jamanetworkopen.2022.15000. PMID: 35653154Free PMC Article
Mycotic aneurysm of the superior and inferior mesenteric artery.
Kordzadeh A, Watson J, Panayiotopolous YP
J Vasc Surg 2016 Jun;63(6):1638-46. Epub 2016 Mar 4 doi: 10.1016/j.jvs.2016.01.031. PMID: 26951998
Pyrexia of unknown origin 90 years on: a paradigm of modern clinical medicine.
Brown M
Postgrad Med J 2015 Dec;91(1082):665-9. Epub 2015 Oct 21 doi: 10.1136/postgradmedj-2015-133554. PMID: 26489766
How to investigate multisystem disease.
Watts RA
Best Pract Res Clin Rheumatol 2014 Dec;28(6):831-43. Epub 2015 May 18 doi: 10.1016/j.berh.2015.04.011. PMID: 26096088
Disseminated cryptococcosis.
Bothra M, Selvaperumal P, Kabra M, Joshi P
Indian Pediatr 2014 Mar;51(3):225-6. doi: 10.1007/s13312-014-0356-5. PMID: 24736916

Prognosis

Pyrexia of unknown origin (PUO) and the cost of care in a tertiary care institute in Sri Lanka.
Premathilaka R, Darshana T, Ekanayake C, Chathurangani KC, Mendis I, Perinparajah S, Shashiprabha M, Nishshanka S, Tilakaratna Y, Premawardhena A
BMC Health Serv Res 2023 Feb 21;23(1):177. doi: 10.1186/s12913-023-09169-1. PMID: 36810045Free PMC Article
Pyrexia of unknown origin.
Fernandez C, Beeching NJ
Clin Med (Lond) 2018 Mar;18(2):170-174. doi: 10.7861/clinmedicine.18-2-170. PMID: 29626024Free PMC Article
Mycotic aneurysm of the superior and inferior mesenteric artery.
Kordzadeh A, Watson J, Panayiotopolous YP
J Vasc Surg 2016 Jun;63(6):1638-46. Epub 2016 Mar 4 doi: 10.1016/j.jvs.2016.01.031. PMID: 26951998
Positron Emission Tomography Computed Tomography: A Guide for the General Radiologist.
Beadsmoore C, Newman D, MacIver D, Pawaroo D
Can Assoc Radiol J 2015 Nov;66(4):332-47. Epub 2015 Aug 12 doi: 10.1016/j.carj.2015.02.003. PMID: 26277234
Management of pyrexia of unknown origin.
Srikugan L, Loganayagam A
Br J Hosp Med (Lond) 2007 Dec;68(12):M212-4. doi: 10.12968/hmed.2007.68.Sup12.27848. PMID: 18186404

Clinical prediction guides

Prospective study of pyrexia with pregnancy.
Mewada BN, Gandhi D, Diwan F, Panchal PN
Ann Afr Med 2023 Jan-Mar;22(1):1-4. doi: 10.4103/aam.aam_75_20. PMID: 36695215Free PMC Article
Epidemic retinitis and community outbreaks.
Kawali A, Srinivasan S, Mahendradas P, Shetty B
Indian J Ophthalmol 2020 Sep;68(9):1916-1919. doi: 10.4103/ijo.IJO_1327_20. PMID: 32823414Free PMC Article
Mycotic aneurysm of the superior and inferior mesenteric artery.
Kordzadeh A, Watson J, Panayiotopolous YP
J Vasc Surg 2016 Jun;63(6):1638-46. Epub 2016 Mar 4 doi: 10.1016/j.jvs.2016.01.031. PMID: 26951998
Pyrexia of unknown origin 90 years on: a paradigm of modern clinical medicine.
Brown M
Postgrad Med J 2015 Dec;91(1082):665-9. Epub 2015 Oct 21 doi: 10.1136/postgradmedj-2015-133554. PMID: 26489766
Disseminated cryptococcosis.
Bothra M, Selvaperumal P, Kabra M, Joshi P
Indian Pediatr 2014 Mar;51(3):225-6. doi: 10.1007/s13312-014-0356-5. PMID: 24736916

Recent systematic reviews

Prospective Studies Comparing Structured vs Nonstructured Diagnostic Protocol Evaluations Among Patients With Fever of Unknown Origin: A Systematic Review and Meta-analysis.
Wright WF, Betz JF, Auwaerter PG
JAMA Netw Open 2022 Jun 1;5(6):e2215000. doi: 10.1001/jamanetworkopen.2022.15000. PMID: 35653154Free PMC Article
Mycotic aneurysm of the superior and inferior mesenteric artery.
Kordzadeh A, Watson J, Panayiotopolous YP
J Vasc Surg 2016 Jun;63(6):1638-46. Epub 2016 Mar 4 doi: 10.1016/j.jvs.2016.01.031. PMID: 26951998
Is there a role for the otolaryngologist in PFAPA syndrome? A systematic review.
Leong SC, Karkos PD, Apostolidou MT
Int J Pediatr Otorhinolaryngol 2006 Nov;70(11):1841-5. Epub 2006 Aug 14 doi: 10.1016/j.ijporl.2006.07.002. PMID: 16908073

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