Fever of unknown origin: is there a role for empiric therapy?
Empiric therapy has little or no role to play in cases of classic fever of unknown origin with three important exceptions: cases that meet criteria for culture-negative endocarditis; cases in which findings or the clinical setting suggests cryptic disseminated tuberculosis (or, occasionally, other granulomatous infections); and cases in which temporal arteritis with vision loss is suspected. Several studies indicate that patients with prolonged, undiagnosed fever of unknown origin generally have a favorable prognosis. A small and largely anecdotal literature suggests a small role for symptomatic use of corticosteroids or nonsteroidal anti-inflammatory agents in highly selected cases.
Department of Medicine, University of South Carolina School of Medicine, Two Medical Park, Suite 502, Columbia, SC 29203, USA. cbryan@gw.mp.sc.edu
Charles S
CS
Bryan
Divya
D
Ahuja
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy; D005335:Fever of Unknown Origin / Q000188:drug therapy*; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000995:Antitubercular Agents