Fever of unknown origin: what is remarkable in the elderly in a developing country?
OBJECTIVE
To investigate fever of unknown origin (FUO) in 97 patients and compare geriatric and adult population.


METHODS
We investigated 97 (22 elderly) patients with FUO using the criteria of Petersdorf and Beeson [Medicine 40 (1961) 1] hospitalized between January 1990 and May 2005 at Hacettepe University Hospital.


RESULTS
Infectious diseases were the most common cause in the adult (33.3%) and the elderly (45.5%) patients both. Neoplasms were seen in 18.7; 4.5% and collagen vascular diseases were diagnosed in 9.3; 4.5% of the adults and the elderly respectively. Tuberculosis accounted for 60% of all the infectious causes and empirical anti-tuberculous treatment served as a diagnostic method in 43% of the cases with tuberculosis. Lymphadenopathy was more common among the adults with FUO. A diagnosis could be reached in all the elderly patients with a very high erythrocyte sedimentation rate (ESR>100mm/h). At the end of the hospitalization, 14.7% (11/75) of the adult patients and 13.6% (3/22) of the elderly patients died.


CONCLUSIONS
Geriatric patients with FUO usually have characteristics similar to the adult patients with respect to the hospitalization time, diagnosis, and inpatient mortality. Lymphoid organ hyperplasia might be expected less frequently and very high ESR might be a more reliable indicator of systemic disease in the elderly. Empirical anti-tuberculous treatment plays an important diagnostic role in the developing countries with a higher prevalence of tuberculosis.
Onal
Ibrahim Koral
IK
Department of Internal Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey. koralonal@yahoo.com
Cankurtaran
Mustafa
M
Cakar
Mustafa
M
Halil
Meltem
M
Ulger
Zekeriya
Z
Doğu
Burcu Balam
BB
Uzun
Omrüm
O
Unal
Serhat
S
Arioğul
Servet
S
D000328:Adult; D000368:Aged; D003095:Collagen Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003906:Developing Countries; D003937:Diagnosis, Differential; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007239:Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology