Common Causes
When investigating a patient with pyrexia of unknown origin (PUO), consider possible aetiologies in each of the following four broad categories: infective, inflammatory, neoplastic and miscellaneous. Address each in turn. Pyrexia of unknown origin is a diagnostic challenge and early involvement of specialists is important
Related Conditions
Pyrexia or fever is a vital characteristic of many diseases that affect our bodies. Though Pyrexia is observed in conditions; like an infection through microorganisms. They may also show up in the cases of severe pathological conditions like cancer and specific blood disorders.
What are the possible aetiologies of pyrexia of unknown origin (PUO)?
Pyrexia of unknown origin in patients with HIV infection can be caused by HIV seroconversion, opportunistic infections at low CD4 cell count levels (especially <200x10 6 cells/L), malignancies at all CD4 count levels, and immune reconstitution inflammatory syndrome (IRIS) after commencing antiretroviral therapy.
What is pyrexia or fever?
People who have nosocomial Pyrexia of unknown origin may need to be hospitalized at the onset of fever. The cause of nosocomial type includes: Immune deficient Pyrexia happens in individuals with compromised insusceptible frameworks. This puts them at increased danger of contamination.
What causes pyrexia in HIV infection?
When should you be hospitalized for pyrexia?
What is fever of unknown origin mean?
Fever of unknown origin (FUO) in adults is defined as a temperature higher than 38.3 C (100.9 F) that lasts for more than three weeks with no obvious source despite appropriate investigation.
How is pyrexia of unknown origin treated?
The treatment of FUO is guided by the final diagnosis, but when no cause is found, antipyretic drugs can be prescribed. Corticosteroids should be avoided in the absence of a diagnosis, especially at an early stage. The prognosis of FUO is determined by the underlying cause.
What does pyrexia stand for?
Medical Definition of pyrexia : abnormal elevation of body temperature : fever.
What are the signs of PUO?
Investigation of PUOHistoryExaminationDrenching night sweats Weight loss Headache Haemoptysis Altered bowel habits Occupation Travel Recreational activities Injecting drug use MedicationsMeasurement of fever Lymphadenopathy Scalp tenderness Hepatosplenomegaly Cardiac murmurs Respiratory auscultation RashesSep 16, 2016
What is the most common cause of fever of unknown origin in older adults?
Noninfectious diseases are the most frequent cause of FUO in the elderly and temporal arteritis the most frequent specific cause. Tuberculosis is the most common infectious disease associated with FUO in elderly patients. FUO often is associated with treatable conditions in the elderly.
What causes pyrexia?
Fever or elevated body temperature might be caused by: A viral infection. A bacterial infection. Heat exhaustion.
What is difference between pyrexia and fever?
When your body temperature goes above 100.4 degrees Fahrenheit (37.5 degrees Celsius), you have a fever — also called pyrexia. So, a very high fever is called hyperpyrexia. If you have hyperpyrexia, then you may also experience: Extreme sweating.
What are the different stages of pyrexia?
There are five patterns: intermittent, remittent, continuous or sustained, hectic, and relapsing. With intermittent fever, the temperature is elevated but falls to normal (37.2°C or below) each day, while in a remittent fever the temperature falls each day but not to normal.
Is pyrexia of unknown origin a diagnosis?
The definition of pyrexia of unknown origin (PUO) dates back to 1961; it was described as a persistent fever above 38.3°C (100°F) that evades diagnosis for at least 3 weeks, including 1 week of investigation in hospital.
How do you treat a patient with pyrexia?
Antipyretic agents, mainly paracetamol and NSAIDs, and physical cooling methods can be used to control pyrexia. Cooling with surface devices is usually preferred for fever control while endovascular methods are more commonly restricted to therapeutic hypothermia.
How is fever of unknown origin diagnosed?
The syndrome of fever of unknown origin (FUO) was defined in 1961 by Petersdorf and Beeson as the following: (1) a temperature greater than 38.3°C (101°F) on several occasions, (2) more than 3 weeks' duration of illness, and (3) failure to reach a diagnosis despite one week of inpatient investigation.
What are the risk factors of pyrexia?
Pyrexia, also known as fever, is an increase in the body temperature of an individual beyond the normal range....Risk factors for Fever:Bronchitis.Sinusitis.Rheumatoid arthritis.Allergic rhinitis (hay fever)
What is the best treatment for PUO?
There are three occasions when empirical treatment is appropriate: antituberculous therapy for suspected miliary or CNS TB, antimicrobials for patients with suspected infective endocarditis and signs of sepsis, and steroid treatment for possible temporal arteritis.
Is pyrexia the same as fever?
Pyrexia, also known as fever, is an increase in the body temperature of an individual beyond the normal range. This increase in temperature is usually considered dangerous, but it is a natural defensive mechanism of the body to fight against infections.
Which of the following tests is most commonly ordered on patients with fever of unknown origin?
The most common invasive tests associated with FUO are biopsies of lymph nodes, liver, bone marrow, epididymal nodule, and temporal artery. These tests are performed only if the clinical picture or initial tests reveal findings that require histopathological evaluation.
How do you manage Hyperpyrexia?
Treatment for hyperpyrexia involves addressing both the increase in body temperature and the condition that's causing it. Sponging or bathing in cool water can help lower your body temperature. Ice packs, blowing cool air, or spraying with cool water may also help.
What is Pyrexia of Unknown Origin (PUO)?
Pyrexia of Unknown Origin (PUO) is a condition in which an individual has elevated body temperature, but despite investigations, no cause or explanation is found for this condition.
Symptoms & signs
In the majority of the cases of PUO, no symptoms other than the persistence of fever are seen.
Diagnosis
A diagnosis of the underlying cause of Pyrexia of Unknown Origin (PUO) may be established based on careful medical history, travel history, sexual history, clinical evaluation, and results of the investigations done.
Treatment options
The treatment of Pyrexia of Unknown Origin (PUO) is based on identifying the underlying cause and its management.
Prognosis
The prognosis of Pyrexia of Unknown Origin (PUO) is directly dependent on the prognosis of the underlying cause.
What causes a classic type of pyrexia of unknown origin?
Classical PUO (1): The cause of a classic type of pyrexia of unknown origin is infections, malignancy, collagen and vascular diseases. The patient has a temperature of 38.3 C for duration of more than 3 weeks. (1,4) The classic type of pyrexia of unknown origin affects previously healthy people.
What is the Treatment of Pyrexia of Unknown Origin (PUO)?
Most of the cases of pyrexia of unknown origin (PUO) are discharged without any definitive diagnosis and in most cases, it resolves on its own. (3) As the mortality rate of pyrexia of unknown origin (PUO) is very low, the doctor does not go with the therapeutic trials, as the early use of antipyretics and antimicrobial may delay the diagnosis of pyrexia of unknown origin. (3)
What is the best treatment for pyrexia?
NSAIDs: Non-steroidal anti-inflammatory drugs and antihistamines are used to treat pyrexia of unknown origin, if no underlying cause is detected. (3) This help in reducing fever.
What is a fever of unknown origin?
Pyrexia of unknown origin, also known as fever of unknown origin, is an unexplained fever despite basic investigations. (2,4) Patients under this category are difficult to diagnose as they have already resisted classification during the baseline investigations. (2)
What causes pyrexia in HIV patients?
Pyrexia of unknown origin in patients with HIV infection can be caused by HIV seroconversion, opportunistic infections at low CD4 cell count levels (especially <200x10 6 cells/L), malignancies at all CD4 count levels, and immune reconstitution inflammatory syndrome (IRIS) after commencing antiretroviral therapy.
When investigating a patient with pyrexia of unknown origin (PUO), consider possible aeti?
When investigating a patient with pyrexia of unknown origin (PUO), consider possible aetiologies in each of the following four broad categories: infective, inflammatory, neoplastic and miscellaneous. Address each in turn. Pyrexia of unknown origin is a diagnostic challenge and early involvement of specialists is important
What are the causes of PUO?
The causes of PUO can be considered in four categories: infective, inflammatory, neoplastic and miscellaneous. The relative prominence of each category has changed over time, with an increasing proportion of patients who remain undiagnosed, which may be up to 51% of cases. 5 Infectious causes account for 17–35% of cases, inflammatory causes 24–36%, neoplastic causes 10–20% and miscellaneous causes 3–15%. 6 An older multimorbid population, increased global travel, HIV infection, the increase in organ transplantation and immunomodulation for many diseases, evolving diagnostics and changing antimicrobial resistance patterns have all changed the management of patients with PUO (Fig 1 ).
Is pyrexia of unknown origin a diagnostic challenge?
Pyrexia of unknown origin is a diagnostic challenge and early involvement of specialists is important. The balance of causes of PUO varies over time and across different patient populations. Investigations should be undertaken based on the most likely cause (s).
