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Fever of unknown origin

Zoltán Szilágyi

on 28 March 2011

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Transcript of FUO

FUO Unknown origin Known? Nosocomial Immune-deficient HIV associated 1961 Petersdorf and Beeson Fever higher than 38.3°C (101°F) on several occasions
Persisting without diagnosis for at least 3 weeks
At least 1 week's investigation in hospital 3 outpatient visits or
3 days in the hospital without elucidation of a cause or
1 week of "intelligent and invasive" ambulatory investigation
Modern definition a.k.a. "The ER ruled out:" Common causes Anamnesis, lab. Infection Skin inflammation Immunological Tissue destruction Cancer Metabolic Thrombo-embolic chest X-ray UH (cardial, abdominal) blood panel CRP urine Classic infection connective tissue diseases miscellaneous undiagnosed SARCOIDOSIS abscess endocarditis TBC urinary tract infection lymphoma leukaemia 20% temporal arteritis Lupus Rheumatoid arthritis alcoholic hepatitis urinary catheter drugs physical exam- NO
+ urine echo - NO we did it? getting worse muscle/joint ache Drama back to square one Lymph nodes Fever increased body temperature
axillary, rectal,
otic, oral = MEASURE
more than 37,5 °C (axillary) = FEVER typhus Febris continua contiens sepsis, malaria Febris intermittens tuberculosis Febris remittens Febris undulans brucellosis, Hodgkin (Pel-Ebstein) Types Every Monday I. Belklinika at 13:00 Doesn't = Exclude these! I have a case for you! Any proper idea? Minor abnormalities on his EKG so... Hey, what's your idea? It could be infection just.... um... something special... He's not that special... + READ THE CHART Could be... He just doesn't know about it yet! Patient likes boys huh? Go test, see if he's ! lying also, antibodies didn't confirm the autoimmune diseases.
It's not Takayasu's arteritis either (angio) neoplasm . . . . . . . . . . . . . . . . . . . . . . . Sadly NO again :( At last we've found something! House sees something totally irrelevant, and solves the case! weight loss fatigue shortness of breath This semester Kérdés?
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