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Possible etiologies of FUO

Possible etiologies of FUO. Infections Localized pyogenic (ex. Appendicitis, Liver abcess) Intravascular infection (ex. Bacterial endocarditis) Systemic (ex. Leptospirosis) Mycobacterial (ex. Tuberculosis) Other bacterial (ex. Actinomycosis) Rickettsial (ex. Anaplasmosis)

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Possible etiologies of FUO

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  1. Possible etiologies of FUO • Infections • Localized pyogenic (ex. Appendicitis, Liver abcess) • Intravascular infection (ex. Bacterial endocarditis) • Systemic (ex. Leptospirosis) • Mycobacterial (ex. Tuberculosis) • Other bacterial (ex. Actinomycosis) • Rickettsial (ex. Anaplasmosis) • Mycoplasmal infections • Chlamydial infections (ex. Lymphogranuloma venereum) • Viral infections (ex. HIV) • Fungal infections (ex. Candidiasis, Pneumocystis) • Parasitic infection (ex. Amoebiasis) • Presumed infections agent undetermined (ex. Kawasaki’s Disease)

  2. Possible etiologies of FUO • Neoplasms • Malignant (ex. Colon cancer) • Benign (ex. Renal angiomyolipoma) • Habitual Hyperthermia • Collagen vascular/ hypersensitivity disease • Ex. Adult Still’s Disease • Granulomatous diseases • Ex. Crohn’s disease • Miscellaneous • Ex. Drug Fever

  3. Possible etiologies of FUO • Inherited and Metabolic Diseases • Ex. Cyclic neutropenia • Thermoregulatory disorders • Central (ex. Brain tumor) • Peripheral (ex. Hyperthyroidism) • Factitious fevers

  4. Possible etiologies for the present case • Drug fever • patient has been taking cardiovascular drugs such as Atenolol and unrecalled antibiotics (may be B-lactam) • Infection • previous travel history may indicate malaria • Patient also has a history of hepatitis A infection, signs such as icteric sclerae • Neoplasm (probably in the GI tract) • Signs and symptoms such as RUQ pain, weight loss, malaise, pale colored stool, icteric sclerae • Patient is >50 years old and is predisposed to have colon cancer

  5. Local Experience (PGH, 1975-1990), unpublishedSource: M.F. Mendoza MD, 29th PSMID Conv Source: PLM trans 2008

  6. Diagnostic Categories of 72 Patients with FUO at the Santo Tomas University Hospital Source: PLM trans 2008

  7. FUO etiology (child vs. adult) CHILD ADULT Infection Neopastic d/o Drug fever Collagen vascular/ hypersensitivity diseases Factitious fever Principal cause: Rheumatological diseases and infections In elderly, most frequent cause is Multi-system disease such as: Infection- TB Malignancy- colon cancer

  8. Frequency of common etiologies of FUO in adults Source: PLM trans 2008

  9. Frequency of common etiologies of FUO in children Source: PLM trans 2008

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