• Title/Summary/Keyword: Fever of Unknown Origin(FUO)

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Case reports on children with FUO(Fever unknown origin) (불명열(不明熱)을 주소(主訴)로 하는 환아(患兒)의 임상예(臨床例) 보고(報告))

  • Min Sang-Yun;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.1
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    • pp.189-196
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    • 2000
  • Recently, By the climatic change and increased resistance to antibiotics, diseases with atypical fever are increasing. FUO(Fever unknown origin) is defined' as fever persisting for $1{\sim}3weeks$ which origins are not found. through the reports of two clinical cases presenting FUO, I pretend to show the orient-medical and west-medical approachs to FUO.

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Diagnostic approach to the fever of unknown origin in children - Emphasis on the infectious diseases - (소아에서 원인불명열의 진단적 접근 - 감염성 질환을 위주로 하여-)

  • Choi, Eun Hwa
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.127-131
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    • 2007
  • Fever of unknown origin (FUO) has been a convenient term used to classify patients who warrant a particular systemic approach to diagnostic evaluation and management. The greatest clinical concern in evaluating FUO is identifying patients whose fever has a serious or life-threatening cause when a delay in diagnosis could jeopardize successful intervention. Thorough history and complete physical examination are critical to uncover the etiologic diagnosis. Most cases of FUO in children are caused by atypical presentations of common diseases rather than by typical manifestations of rare disorders. Selection of diagnostic tests and speed of investigation should be guided by a knowledge of the disease severity, patient age, epidemiologic and geographic information, and any positive findings from a detailed history and physical examination. The three most common causes of FUO in children are infectious diseases, connective tissue diseases, and malignancy. In general, the prognosis of FUO in children is better than that of adults. Although the outcome is dependent on the primary disease process, fever abates spontaneously in most cases in whom the cause of fever remains unclear.

Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center

  • Kim, Yi-Seul;Kim, Kyung-Ran;Kang, Ji-Man;Kim, Jong-Min;Kim, Yae-Jean
    • Clinical and Experimental Pediatrics
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    • v.60 no.3
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    • pp.77-85
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    • 2017
  • 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 ${\geq}38.0^{\circ}C$ for longer than ${\geq}14days$ and failure to reach a diagnosis after one week of investigations were included. Results: Total 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%). Conclusion: Almost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.

A Study on the Fever of Unknown Origin Indicated by Janggam Disease (장감병(長感病)으로 진단된 불명열 환자 치험 1례)

  • Kim, Sang Jin;Jang, Seok Hyun;Jung, Hee Jae;Jung, Sung Ki;Lee, Beom Joon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.6
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    • pp.683-688
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    • 2014
  • Fever of Unknown Origin(FUO) is defined as a temperature higher than 38.3'C that persists without diagnosis for at least 3 weeks despite appropriate investigation. The purpose of this study was to analyze the effectiveness of oriental medical treatment on the patient with FUO. We treated a female patient with FUO by oriental medical treatment with appropriate herbal medicine and balanced acupuncture. We prescribed Galgunhaegi-tang (Gegenjieji-tang) for 5 days and Handayeolso-tang(Handuoreshao-tang) for 9 days. At the same period, we also applied acupuncture and checked body temperature. In order to measure a pain of the patient, we used Visual Analogue Scale(VAS). It was found that Galgunhaegi-tang had little effect at this time, but the administration of Handayeolso-tang brought the positive effect on the patient. The body temperature of the patient was lowered and VAS score was reduced apparently after treatment. Handayeolso-tang might be used for relieving symptoms of FUO.

A Clinical Study of the Treatment Prescribed Kalkunhaeki-tang for FUO (Fever of Unknown Origin) Patient (원인 불명열 환자를 갈근해기탕(葛根解肌湯)으로 치험한 1례)

  • Yim, Chi-Hye;Cho, Jae-Seung;Kim, Hyo-Soo;Kwon, Seung-Man;Kim, Shin;Kim, Il-Hwan;Park, Hye-Sun
    • Journal of Sasang Constitutional Medicine
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    • v.19 no.2
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    • pp.223-229
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    • 2007
  • 1. Objectives FUO is defined as a temperature higher than $38.3^{\circ}C$ on several occasions and lasting longer than 3 weeks, with a diagnosis that remain uncertain after 1 week of investigation. Diagnosing the cause of FUO is particularly difficult. 2. Methods We have tried researching effect of herbal medicines(Kalkunhaeki - tang treatments) and Acupoint Injection to Taeumin FUO patient. 3. Results A Taeumin patient diagnosed to FUO was treated with Taeumin herbal medicines(kalkunhaeki - tang treatments) and change of patient's fever and general condition were improved. 4. Conclusions The constitutional treatment with Kalkunhaeki - tang may have an effect on management of FUO. So we report the healing process and results of this patient in this study.

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Three Cases of Fever Unknown Origin with Lymphoproliferative Features and a Unique Pattern of 18-FDG Uptake on the Fusion PET/CT

  • Yun, Dae-Young;Hong, Young-Hoon;Jung, Yong-Uk;Oh, Myung-Jin;Lee, Choong-Ki
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.64-71
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    • 2008
  • Evaluation of a fever of unknown origin (FUO) is complex. Recently, PET scanning has been approved for screening in FUO evaluation. We treated three cases of FUO associated with increased FDG uptake in the bone marrow of the femur and tibia on the fusion PET/CT; all three had the same pattern of uptake. Bone marrow biopsies revealed mature lymphocyte and histiocyte infiltration and myxoid changes in one case, and cortical bone involvement in another case. The cases were all young females who had fever with neutropenia and relative lymphocytosis that lasted for several weeks and then remitted spontaneously. Even though the results of the studies were not diagnostic, the unique uptake pattern on PET/CT and the histology might be related to the cause of the illness and should be studied further to assess the association with classic FUO.

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Clinical Value of Dual-phase 18F-FDG SPECT with Serum Procalcitonin for Identification of Etiology in Tumor Patients with Fever of Unknown Origin

  • Zhang, Qun;Shan, Chun;Wu, Pei;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.683-686
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    • 2014
  • Objective: The purpose of the study was to evaluate clinical value of dual-phase $^{18}F$-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO). Methods: PCT test and dual-phase $^{18}F$-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all $^{18}F$-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual-phase $^{18}F$-FDG SPECT and bacterial cultivation, regarded as a gold standard. Results: Among 50 patients, 34 demonstrated PCT ${\geq}0.5{\mu}g/L$. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase $^{18}F$-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up. Conclusion: Our study demonstrated that dual-phase $^{18}F$-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.

A Case Report of Sibimijihwang-tang(十二味地黃湯) Treatment of a Soyangin Yin-Deficit Diurnal-Heat Symptomatology(陰虛惡熱證) Patient Presenting with Fever of Unknown Origin (원인미상의 발열(發熱)을 동반한 소양인(少陽人) 음허오열증(陰虛午熱證) 환자에 대한 십이미지황탕(十二味地黃湯) 치험(治驗) 1례)

  • Kim, Seong-Ki;Lee, Pil-Jae;Song, Eun-Young;Lim, Eun-Chul;Jung, Won-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.22 no.4
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    • pp.124-129
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    • 2010
  • 1. Objectives The purpose of this case is to report the effects of Sibimijihwang-tang(十二味地黃湯) which is based on Sasang constitutional Medicine for Yin-Deficit Diurnal-Heat Symptomatology(陰虛午熱證) in Soyangin. 2. Methods We treated a Soyangin patients that had Fever Unknow Origin. We prescribed Sibimijihwang-tang(十二味地黃湯) for her physical symptoms. The improvement of her diseases was evaluated by her fever and other physical symptoms. 3. Results After the Sasang constitutional medication of Sibimijihwang-tang(十二味地黃湯) was given, the patient's fever and physical symptoms were improved. 4. Conclusions This case study show an efficient result of using Sibimijihwang-tang(十二味地黃湯) in the Yin-Deficit Diurnal-Heat Symptomatology(陰虛午熱證) of Soyangin.

Non-specific Inflammatory Disease Showed Abnormal FDG Uptake in Lower Extremities ($^{18}F-FDG$ PET/CT 에서 하지골 골수에 다발성 이상섭취를 보인 비특이성 염증성질환)

  • Chun, Kyung-Ah;Kong, Eun-Jung;Cho, Ihn-Ho;Hong, Young-Hoon;Lee, Choong-Ki
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.79-80
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    • 2008
  • Including malignancy, various disease can show abnormal uptake in bone marrow. We report a case of non-specific inflammatory FDG uptake in bone marrow mimicking malignancy. A 35-year old woman with fever of unknown origin (FUO) underwent $^{18}F$-FDG PET/CT to find out fever $^{18}F$-FDG and unknown malignancy. $^{18}F$-FDG was injected and imaged 1hr after injection with Discovery ST (GE, USA), $^{18}F$-FDG PET/CT whole body image showed abnormal uptake in lower extremities (Fig. 1). MRI and biopsy was also done in the sites of abnormal uptake. PET and MRI suspect malignancy (Fig. 2, 3), but biopsy result was non-specific inflammatory process (Fig. 4). The patient was improved her clinical condition after antibiotics therapy.

A Case of Subacute Necrotizing Lymphadenitis Presenting as Fever of Unknown Origin (불명열로 오인된 아급성 괴사성 림프선염 1례)

  • Yang, In Suk;Park, Kyung Ho;Kang, Jin Han;Kim, So Young;Lee, Won Bae;Kim, Hyun Hee
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.253-259
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    • 2001
  • Kikuchi's disease(histiocytic necrotizing lymphadenitis) is characterized by lymphadenopathy in young patients below 30 years old, and persistent fever, lymphopenia and splenomegaly are concomitantly developed in many cases. So, it has been confused with lymphoma, SLE, and tuberculosis, and has easily led to inappropriate diagnostic procedures and administration of drugs. Many reports have indicated that Kikuchi's disease should be added to the list of causes of FUO in the setting of lymphadenopathy, and recommended early lymph node biopsy to distinguish from lymphoma, SLE, and tuberculosis to avoid unnecessary treatments. We experienced a case of subacute necrotizing lymphadenitis in a 14-year-old boy who presented with persistent high fever, productive coughing and cervical lymphadenopathy for about 1 month. Initially, diagnostic workup was done to look for the causes of FUO in vain. Finally, we confirmed diagnosis by histopathological findings of lymph node biopsy and detected latent gene of EBV in the biopsied specimen using in situ hybridization.

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