Fever of unknown origin: a clinical approach

Am J Med. 2015 Oct;128(10):1138.e1-1138.e15. doi: 10.1016/j.amjmed.2015.06.001. Epub 2015 Jun 18.

Abstract

Fevers of unknown origin remain one of the most difficult diagnostic challenges in medicine. Because fever of unknown origin may be caused by over 200 malignant/neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders, clinicians often order non-clue-based imaging and specific testing early in the fever of unknown origin work-up, which may be inefficient/misleading. Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach. Characteristic history and physical examination findings together with key nonspecific test abnormalities are the basis for a focused clue-directed fever of unknown origin work-up.

Keywords: Adult fevers of unknown origin; Fevers of unknown origin; Focused diagnostic approach.

Publication types

  • Review

MeSH terms

  • Clinical Decision-Making / methods*
  • Diagnosis, Differential
  • Fever of Unknown Origin / etiology*
  • Humans
  • Medical History Taking*
  • Physical Examination*
  • Unnecessary Procedures