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Fever of Unknown Origin in Adults

 Fever of Unknown Origin (FUO) was first defined in 1961 as the following:

• Temperature greater than 38.3 C or 101 F on repeated occasions
• Illness lasting more than two weeks
• Failure to reach a diagnosis after one week of inpatient investigation

Diagnostic advances have continued to expand the spectrum of diseases which can cause FUO. Imaging techniques such as ultrasounds, CT scans or MRIs also enable the early detection of abcesses and solid masses which are difficult to diagnose but which can also cause FUO.

Patients with FUO generally have a benign long-term cause, especially when the fever isn’t accompanied by substantial weight loss or other signs of a serious disease. Prognosis will obviously vary from patient to patient depending on the underlying cause.

The following conditions can cause FUO:
• Abcesses
• Tuberculosis
• HIV
• Urinary Tract Infections
• Osteomyelitis
• Herpes virus
• Lymphoma
• Leukaemia
• Solid tumours
• Sarcoidosis
• Drug fever
• Giant cell arteritis
• Polymyalgia rheumatic
• Polyarteritis nodosa

Self care at home:
You should use a medication to reduce your fever such as ibuprofen, acetaminophen or aspirin and cool yourself down with a cold sponge. You should drink plenty of liquids and avoid alcohol.

When should you seek medical attention?
You should consider visiting a doctor if your temperature is 39 c or above, the fever has persisted for more than one week or your fever symptoms get worse. You should consider going to the ER if any of the following symptoms occur alongside your fever:
• Confusion
• Neck stiffness
• Severe headache
• Chest pain
• Sore throat with drooling
• Repeated vomiting
• Skin rash
• Difficulty breathing
• Leg swelling
• Blood in stool or urine
• Red, hot, swollen skin area

What will doctors do if they see a patient with FUO?
Doctors will take a full medical history and conduct a thorough physical examination to try to find the source of the fever. If they still cannot be sure of a diagnosis, they will do a number of further tests which could include:
• CBC
• Strep throat culture
• Sputum sample
• Blood culture
• Urine analysis and culture
• Stool sample
• Lumbar ouncture
• X-Ray or CT scan
• Liver tests
• Thyroid function scan

Hopefully, the doctor should be able to find the cause of the fever based on these tests, but if not specialists may need to be involved to determine further diagnostic testing.

EHL

For more information about any of EHL’s facilities, please visit www.ehl.ae

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