Evaluating fever of unknown origin definitions in a tertiary care setting:Implications for diagnostic criteria revision  

作　　者：Pathik Dhangar Prasan Kumar Panda Ravi Kant Rohit Gupta Ruchi Dua Ashutosh Tiwari Sandeep Saini Kavita Khoiwal Yogesh Bahurupi 

机构地区：[1]Department of Medicine,All India Institute of Medical Sciences,Rishikesh 249203,Uttarākhand,India [2]Department of Gastroenterology,All India Institute of Medical Sciences,Rishikesh 249203,Uttarākhand,India [3]Department of Pulmonology,All India Institute of Medical Sciences,Rishikesh 249203,Uttarākhand,India [4]Department of Neurology,All India Institute of Medical Sciences,Rishikesh 249203,Uttarākhand,India [5]Department of Obstetrics and Gynecology,All India Institute of Medical Sciences,Rishikesh 249203,Uttarākhand,India [6]Department of Community and Family Medicine,All India Institute of Medical Sciences,Rishikesh 249203,Uttarākhand,India

出　　处：《World Journal of Experimental Medicine》2025年第2期103-108,共6页世界实验医学杂志(英文)

摘　　要：BACKGROUND Fever of unknown origin(FUO)remains a diagnostic challenge and was originally defined in 1961.Its classic criteria include fever≥38.3°C(≥101°F)on multiple occasions,fever lasting three weeks or longer,and a diagnosis after one week of inpatient evaluation.However,these criteria may not fully encompass the varied clinical presentations seen in resource-limited settings such as India.The adaptation of FUO definitions to local healthcare contexts is crucial for enhancing diagnostic accuracy and optimizing patient outcomes.AIM To investigate the applicability of revised FUO criteria in a tertiary care setting in India.METHODS This longitudinal-exploratory study at All India Institute of Medical Sciences Rishikesh(January 2018–December 2022)analyzed 228 adult patients with fever≥99.1°F lasting over three days.Patients diagnosed within three days of admission were excluded.Data were collected retrospectively and prospectively using predefined FUO definitions based on durations of nondiagnosis(3-21 days,>21 days),temperature ranges(99.1°F-100.9°F,≥101°F),and hospitalization durations(3-7 days,>7 days).Descriptive statistics and comparative tests(Fisher's exact test,χ2 test)evaluated outcomes across definitions.RESULTS Among the proposed FUO definitions,Definition B(fever lasting 3-21 days,temperatures between 99.1°F-100.9°F,hospitalization>7 days)predominated(40.8%),while only 2.2%met the classical criteria.Notably,36.5%of Definition B patients remained undiagnosed after 7-10 days,despite 94%undergoing diagnostic workups within 21 days.Infection emerged as the leading etiology across definitions,without significant variation in outcomes or mortality during hospitalization(χ2=27.937,P=0.142).CONCLUSION Adapting FUO criteria to local contexts improves diagnostic accuracy and treatment.Definition B(40.8%prevalence)showed practical utility,with higher mortality in patients discharged on empirical'Anti-tuberculosis therapy'.

关 键 词：Empirical therapy New definition Pyrexia of unknown origin TUBERCULOSIS 

分 类 号：R51[医药卫生—内科学]