[Low-grade fever of protracted course. Retrospective study of 30 cases and reflections for a low-cost management].
The objects of this paper were the following: 1) to establish in a group of persistent (over four weeks) low grade fever (LGF) patients the percentage of cases in which a definite diagnosis could not be made; 2) where a definite diagnosis could be made, to describe the most commonly occurring diseases; 3) to follow up the uncertain diagnosis cases for at least two years. Thirty cases of persistent LGF were retrospectively studied. They did not include drug hyper-dysthermia and temporary and/or metabolic vasomotor reactions. The data suggest that: 1) two thirds of persistent LGF are likely not to be definitely diagnosed; 2) some certain diagnoses were: dental granulomas, mycobacteria infections, thyroiditis, factitious fever, rheumatic polymyalgia, Hodgkin's lymphoma and pulmonary thromboembolism; 3) in 14/19 undiagnosed cases the fever subsided permanently, without any treatment, within one year, whereas it persisted in 5/19, but no deterioration of the overall clinical status was observed; 4) although some of the undiagnosed cases were examined elsewhere, a certain diagnosis was never achieved in spite of their undergoing sophisticated and expensive clinical, laboratory and X-ray tests. Therefore it is concluded that: 1) persistent LGF should be managed more conservatively than fever of unknown origin so as to preserve resources; 2) some diseases should be included in the differential diagnoses from the beginning of the initial clinical work up; 3) undiagnosed LGF fever either subsides and returns to normal within one year or the fever persists, but no deterioration of the clinical and performance status is likely to occur.
Istituto di Patologia Medica, Università, Ancona.
N
N
Campanella
M
M
Pergolini
P
P
Morosini
D000293:Adolescent; D000328:Adult; D000368:Aged; D001831:Body Temperature; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors