Fever of unknown origin

Defined as temp >38°C (101°F) that last at least 3 weeks and remains undiagnosed despite evaluation over 3 OP visits or 3 hospital days.

• • Infection, CA (25 - 40%),

  • autoimmune dz

  • immigrants from developed countries

  • nosocomial, neutropenic, HIV-associated.

PE: Check fundi, conjunctivae, sinuses, HEENT, temporal a, LAD, heart murumurs, splenomegaly, CVA fullness/tenderness, perirectal or prostatic fluctuance/tenderness

DDx: endocarditis, TB, occult abscess, lymphoma, leukemia, hepatoma, renal cell ca, atrial myxoma, SLE, cryoglobulinemias, polyarteritis nodosa, temporal arteritis, polymyalgia rheumatica, adult Still's dz, drug fever, hyperthyroidism or thyroditis, granulomatous hepatitis, sarcoidosis, Crohn's dz, Whipple's dz, familial Mediterranean fever, recurrent pulmonary embolism, retroperitoneal hematoma, and factitious fever, 10 - 15% no diagnosis can be found.