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https://www.readbyqxmd.com/read/29036369/referral-of-patients-with-fever-of-unknown-origin-to-an-expertise-center-has-high-diagnostic-and-therapeutic-value
#1
Catharina M Mulders-Manders, Gianni Pietersz, Anna Simon, Chantal P Bleeker-Rovers
Background: up to 50% of patients with fever of unknown origin (FUO) remain undiagnosed despite extensive evaluation. In expertise centers, at least 25-63% of these patients is referred after evaluation in another hospital. The diagnostic and therapeutic yields of referral to an expertise center are currently unknown. Aim: To determine the diagnostic and therapeutic yield of referral of patients with fever of unknown origin (FUO) that remain undiagnosed in non-expertise hospitals...
July 28, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28970828/diagnostic-criteria-for-adult-onset-periodic-fever-aphthous-stomatitis-pharyngitis-and-cervical-adenitis-pfapa-syndrome
#2
Luca Cantarini, Antonio Vitale, Ludovico Luca Sicignano, Giacomo Emmi, Elena Verrecchia, Isabella Patisso, Lucia Cerrito, Claudia Fabiani, Gabriele Cevenini, Bruno Frediani, Mauro Galeazzi, Donato Rigante, Raffaele Manna
OBJECTIVE: To identify a set of variables that could discriminate patients with adult-onset periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome from subjects with fever of unknown origin (FUO). METHODS: We enrolled 74 adults diagnosed with PFAPA syndrome according to the currently used pediatric diagnostic criteria and 62 additional patients with FUO. After having collected clinical and laboratory data from both groups, univariate and multivariate analyses were performed to identify the variables associated with PFAPA diagnosis...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28928271/the-value-of-18-f-fdg-pet-ct-in-identifying-the-cause-of-fever-of-unknown-origin-fuo-and-inflammation-of-unknown-origin-iuo-data-from-a-prospective-study
#3
Verena Schönau, Kristin Vogel, Matthias Englbrecht, Jochen Wacker, Daniela Schmidt, Bernhard Manger, Torsten Kuwert, Georg Schett
BACKGROUND: Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are diagnostically challenging conditions. Diagnosis of underlying disease may be improved by (18)F-fluorodesoxyglucose positron emission tomography ((18)F-FDG-PET). METHODS: Prospective study to test diagnostic utility of (18)F-FDG-PET/CT in a large cohort of patients with FUO or IUO and to define parameters that increase the likelihood of diagnostic (18)F-FDG-PET/CT. Patients with FUO or IUO received (18)F-FDG-PET/CT scanning in addition to standard diagnostic work-up...
September 19, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28925085/-18-f-fdg-pet-ct-as-adjunctive-diagnostic-modalities-in-canine-fever-of-unknown-origin
#4
Megan Grobman, Leah Cohn, Stephanie Knapp, Jeffrey N Bryan, Carol Reinero
Fever of unknown origin (FUO) is a persistent or recurrent fever for which the underlying source has not been identified despite diagnostic investigation. In people, (18) F-fluoro-2-deoxyglucose positron emission tomography ((18) F-FDG-PET) alone or in combination with computed tomography (CT) is often beneficial in detecting the source of fever when other diagnostics have failed. Veterinary reports describing use of these modalities in animals with fever of unknown origin are currently lacking. Aims of this retrospective case series were to describe (18) F-FDG-PET or (18) F-FDG-PET/CT findings in a group of dogs with fever of unknown origin...
September 18, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28856437/diagnosis-and-empirical-treatment-of-fever-of-unknown-origin-fuo-in-adult-neutropenic-patients-guidelines-of-the-infectious-diseases-working-party-agiho-of-the-german-society-of-hematology-and-medical-oncology-dgho
#5
REVIEW
W J Heinz, D Buchheidt, M Christopeit, M von Lilienfeld-Toal, O A Cornely, H Einsele, M Karthaus, H Link, R Mahlberg, S Neumann, H Ostermann, O Penack, M Ruhnke, M Sandherr, X Schiel, J J Vehreschild, F Weissinger, G Maschmeyer
Fever may be the only clinical symptom at the onset of infection in neutropenic cancer patients undergoing myelosuppressive chemotherapy. A prompt and evidence-based diagnostic and therapeutic approach is mandatory. A systematic search of current literature was conducted, including only full papers and excluding allogeneic hematopoietic stem cell transplant recipients. Recommendations for diagnosis and therapy were developed by an expert panel and approved after plenary discussion by the AGIHO. Randomized clinical trials were mainly available for therapeutic decisions, and new diagnostic procedures have been introduced into clinical practice in the past decade...
November 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28852831/uterine-intravascular-lymphoma-as-a-cause-of-fever-of-unknown-origin
#6
Jérôme Hadjadj, Hubert Nielly, Eve Piekarski, Wendy Cuccuini, Bénedicte Deau-Fischer, Muriel Hourseau, Khadija Benali, Claire Fieschi, Marc Aletti, Thomas Papo, Eric Oksenhendler, Lionel Galicier, David Boutboul
Primary intravascular large B cell lymphoma (IVL) remains a diagnostic challenge because of non-specific clinical, laboratory and imaging findings. The aim of the study was to analyse the major characteristics of IVL with uterine involvement. We retrospectively collected features of IVL with uterine involvement that was proven histologically or demonstrated by significant (18)FDG uptake on (18)FDG-PET/CT. Findings were compared to a comprehensive literature review. Five patients were identified. All of them were admitted for fever of unknown origin (FUO), with haemophagocytic lymphohistiocytosis in three cases...
August 29, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28768449/recurrent-fuo-due-to-intermittent-enterobacter-cloacae-bacteremias-from-an-infected-pacemaker-lead-diagnosed-by-gallium-scan
#7
Burke A Cunha, Ismail Jimada
Fever of unknown origin (FUO) refers to fevers of ≥101° F that persist for ≥3 weeks and remain undiagnosed after a focused inpatient or outpatient workup. FUO may be due to infectious, malignant/neoplastic, rheumatic/inflammatory, or miscellaneous disorders. Recurrent FUOs are due to the same causes of classical FUOs. Recurrent FUOs may have continuous or intermittent fevers and are particularly difficult to diagnose. With intermittent fever, recurrent FUO diagnostic tests are best obtained during fever episodes...
August 2, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28737201/-paniculitis-as-manifestation-of-prolonged-febrile-syndrome-case-report
#8
Alexa Puchi Silva, Paulina López Radrigán, Montserrat Zapico Lafuente, Sergio Tapia Carrere, Sergio González Bombardiere
Fever of unknown origin (FUO) is defined as fever over 7 to 10 days without a diagnosis despite a complete initial study. The most frequent causes are infections, autoimmune and tumors. Even though most cases are self-limited there is a minority that has an underlying etiology with an ominous forecast, encouraging a systematized study. OBJECTIVE: To report a rare case of a boy who presented fever of unknown origin associated to panniculitis and was diagnosed of subcutaneous panniculitis-like-T cell lymphoma and to emphasis the importance of a sequential study of FUO, in order to reach a diagnosis in patients who need a timely intervention...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28726033/recommendations-for-the-inclusion-of-fabry-disease-as-a-rare-febrile-condition-in-existing-algorithms-for-fever-of-unknown-origin
#9
Raffaele Manna, Roberto Cauda, Sandro Feriozzi, Giovanni Gambaro, Antonio Gasbarrini, Didier Lacombe, Avi Livneh, Alberto Martini, Huri Ozdogan, Antonio Pisani, Eleonora Riccio, Elena Verrecchia, Lorenzo Dagna
Fever of unknown origin (FUO) is a rather rare clinical syndrome representing a major diagnostic challenge. The occurrence of more than three febrile attacks with fever-free intervals of variable duration during 6 months of observation has recently been proposed as a subcategory of FUO, Recurrent FUO (RFUO). A substantial number of patients with RFUO have auto-inflammatory genetic fevers, but many patients remain undiagnosed. We hypothesize that this undiagnosed subgroup may be comprised of, at least in part, a number of rare genetic febrile diseases such as Fabry disease...
July 19, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28672417/-infections-as-a-cause-of-unexplained-fever
#10
REVIEW
Bernd Salzberger, Gabriele Birkenfeld, Michael Iberer, Florian Hitzenbichler
Fever of unexplained (or unknown) origin (FUO) remains a relevant clinical problem even with modern diagnostic methods. In addition to the classical definition, new categories of FUO describe different clinical situations: nosocomial FUO, FUO in neutropenic/immundeficient patients and FUO in patients with HIV-infection. The new categories are defined by much shorter duration of fever, i. e. mostly three days. Each category of FUO shows a different spectrum of infectious diseases. Often, subacute bacterial endocarditis is very difficult to verify...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28652213/the-efficacy-of-18-f-fdg-pet-ct-and-67-ga-spect-ct-in-diagnosing-fever-of-unknown-origin
#11
Bor-Tau Hung, Pei-Wen Wang, Yu-Jih Su, Wen-Chi Huang, Yen-Hsiang Chang, Shu-Hua Huang, Chiung-Chih Chang
OBJECTIVE: Fever of unknown origin (FUO) is a diagnostic challenge. This study aimed to assess the efficacy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and gallium-67 single-photon emission computed tomography/computed tomography ((67)Ga SPECT/CT) in diagnosing FUO. METHODS: A total of 68 patients with FUO underwent (18)F-FDG PET/CT and (67)Ga SPECT/CT from January 2013 through May 2016. Images were read independently...
June 23, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28600002/diagnostic-yield-of-fdg-pet-ct-in-fever-of%C3%A2-unknown-origin-a-systematic-review-meta-analysis-and-delphi-exercise
#12
REVIEW
T Bharucha, A Rutherford, S Skeoch, A Alavi, M Brown, J Galloway
AIM: To perform a systematic review, meta-analysis and Delphi exercise to evaluate diagnostic yield of combined 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography and computed tomography (FDG-PET/CT) in fever of unknown origin (FUO). MATERIALS AND METHODS: Four databases were searched for studies of FDG-PET/CT in FUO 1/1/2000-1/12/2015. Exclusions were non-English language, case reports, non-standard FDG radiotracer, and significant missing data...
September 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28586777/patients-with-fever-of-unknown-origin-and-splenomegaly-diagnostic-value-of-splenectomy-and-preoperative-risk-factors-suggestive-of-underlying-lymphomas
#13
Lu Zhang, Wei Zhang, Huacong Cai, Xinxin Cao, Miao Chen, Jian Li, Tienan Zhu, Minghui Duan, Shujie Wang, Bing Han, Daobin Zhou
BACKGROUND: We reviewed patients with fever of unknown origin (FUO) and splenomegaly and assessed the diagnostic value of splenectomy and measured risk factors suggestive of an underlying lymphoma. METHODS: FUO patients (n = 83) who had splenomegaly and underwent splenectomy were enrolled into this retrospective single-center study. Clinical presentations were documented and risk factors suggestive of an underlying lymphoma were tested. RESULTS: Seventy-four patients (89...
2017: Acta Haematologica
https://www.readbyqxmd.com/read/28573444/lung-lesions-during-fever-of-unknown-origin
#14
Renata Krupa, Tadeusz M Zielonka, Malgorzata Hadzik-Blaszczyk, Kazimierz A Wardyn, Katarzyna Zycinska
Fever of unknown origin (FUO) remains one of the most difficult diagnostic challenges. The causes of FUO can be various diseases located in different organs. The aim of the study was to determine the prevalence and nature of pulmonary lesions during FUO. One hundred and sixty one patients with FUO participated in this prospective study. We performed a detailed comprehensive history, physical examination, and a wide spectrum of tests. The most common causes of FUO were infections (39%), autoimmune conditions (28%), and neoplasms (17%)...
June 2, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28461685/intravascular-large-b-cell-lymphoma-presenting-as-fever-of-unknown-origin-and-diagnosed-by-random-skin-biopsies-a-case-report-and-literature-review
#15
Horacio di Fonzo, Damian Contardo, Diego Carrozza, Paola Finocchietto, Adriana Rojano Crisson, Cecilia Cabral, Maria de Los Angeles Juarez
BACKGROUND Intravascular lymphoma (IVL) is a rare lymphoproliferative disorder characterized by the proliferation of large B lymphoma cells within the lumen of small-caliber blood vessels. Clinical features are nonspecific, presenting as a systemic disease with fever and may be life-threatening. Antemortem diagnosis is difficult but may be made with biopsies of affected tissues or with random skin biopsies. CASE REPORT We report the case of a 66-year-old white woman presenting with fever of unknown origin (FUO) who developed neurologic, pulmonary, and hematologic manifestations...
May 2, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28457513/fatal-disseminated-histoplasmosis-presenting-as-fuo-in-an-immunocompetent-italian-host
#16
Alessandro Bonsignore, Giulio Fraternali Orcioni, Rosario Barranco, Francesco De Stefano, Jean Louis Ravetti, Francesco Ventura
Histoplasmosis is a relatively rare infectious disease endemic to certain geographic areas such as East Africa, eastern and central United States, western Mexico, Central and South America. Disseminated histoplasmosis has been reported mainly in immunocompromised hosts and in AIDS patients. In this paper we report on a fatal case of undiagnosed disseminated histoplasmosis presenting as fever of unknown origin (FUO) in a 43-year-old Italian woman who, although splenectomized 5years earlier due to a motor vehicle accident, was otherwise immunocompetent...
March 2017: Legal Medicine
https://www.readbyqxmd.com/read/28397053/applied-value-of-monitoring-serum-hepcidin-in-differential-diagnosis-of-infection-versus-tumor-fevers
#17
Ling Li, Jiang-Guo Zhang, Man-Zhi Zhao, Zhu-Hua Wu, Jian-Xin Song
The applied value of serum hepcidin in differential diagnosis of infection fevers versus tumor fevers was explored. A total of 432 fever patients were selected according to the domestic fever of unknown origin (FUO) diagnostic criteria from our hospital between June 2010 and November 2013. Venous blood samples were taken on the day 1, 5, 10 after admission. The infection group (98 cases) and the tumor group (50 cases) were set up based on the clinical and laboratory findings. ELISA was used to determine the serum hepcidin and IL-6 levels...
April 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28392823/etiology-and-clinical-characteristics-of-fever-of-unknown-origin-in-children-a-15-year-experience-in-a-single-center
#18
Yi-Seul Kim, Kyung-Ran Kim, Ji-Man Kang, Jong-Min Kim, Yae-Jean Kim
PURPOSE: Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. METHODS: Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ≥38...
March 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28365283/-epidemiological-and-clinical-characteristics-of-infants-admitted-to-hospital-due-to-human-parechovirus-infections-a-prospective-study-in-spain
#19
Fernando Martín Del Valle, Cristina Calvo, Inés Martinez-Rienda, Amaia Cilla, María P Romero, Ana Isabel Menasalvas, Leticia Reis-Iglesias, Diana Roda, María J Pena, Nuria Rabella, María Del Mar Portugués de la Red, Gregoria Megías, Antonio Moreno-Docón, Almudena Otero, María Cabrerizo
INTRODUCTION: Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever of unknown origin (FUO), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. PATIENTS AND METHODS: A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5...
March 29, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28357088/fever-of-unknown-origin-revealed-to-be-primary-splenic-lymphoma-a-rare-case-report-with-review-of-the-literature
#20
Pan-Ge Sun, Bei Cheng, Jin-Feng Wang, Ping He
Fever is a common clinical presentation of a number of diseases. A sustained unexplained fever >38.3°C lasting for >3 weeks without an established diagnosis despite intensive diagnostic evaluation is referred to as fever of unknown origin (FUO). FUO remains a clinical challenge for physicians, as it may be attributed to a wide range of disorders, mainly infections, malignancies, non-infectious inflammatory diseases and miscellaneous diseases. We herein report the case of a 59-year-old male patient who presented with prolonged unexplained fever and was found to have a diffusely enlarged hypermetabolic spleen, as shown on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography examination...
February 2017: Molecular and Clinical Oncology
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