Fergus To. UBCMJ 2013 4(2):14-16.
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ABSTRACT
Fever of unknown origin (FUO) in the adult population remains a common challenge in clinical practice. Currently, a systematic
approach to working up an admitted patient includes a thorough history and physical exam. The most likely cause can then be assigned to
one of four broad categories: infection, inflammation, malignancy, or miscellaneous. These broader classes help guide initial diagnostic
tests and avoid unnecessary, more invasive procedures. Nevertheless, despite a thorough workup, as many as 30% of all FUO cases
are never solved. The current evidence points to a favourable prognosis for these cases and, thus, empiric treatment is generally not
recommended. This review aims to help clinicians understand the broad differential diagnosis of FUO, and provides a summary of the
current literature and evidence–based recommendations for working up FUO.
KEYWORDS: fever, unknown origin, infection, diagnosis
Fever of unknown origin (FUO) in the adult population remains a common challenge in clinical practice. Currently, a systematic
approach to working up an admitted patient includes a thorough history and physical exam. The most likely cause can then be assigned to
one of four broad categories: infection, inflammation, malignancy, or miscellaneous. These broader classes help guide initial diagnostic
tests and avoid unnecessary, more invasive procedures. Nevertheless, despite a thorough workup, as many as 30% of all FUO cases
are never solved. The current evidence points to a favourable prognosis for these cases and, thus, empiric treatment is generally not
recommended. This review aims to help clinicians understand the broad differential diagnosis of FUO, and provides a summary of the
current literature and evidence–based recommendations for working up FUO.
KEYWORDS: fever, unknown origin, infection, diagnosis
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