Fever of unknown origin: 98 cases from Saudi Arabia.
OBJECTIVE
Fever of unknown origin (FUO) is mainly secondary to infectious, neoplastic or inflammatory diseases. To increase the body of knowledge on this diagnosis in the region, we collected information on all patients admitted to our institution with FUO in a 13-year period.


METHODS
We conducted a retrospective chart review of all immunocompetent males and females aged 13 years and older admitted between January 1995 and June 2008 who fulfilled the criteria for FUO. Data collection included demographics, laboratory investigations, imaging studies, procedures and discharge diagnoses. For true FUO, we recorded the duration of follow-up and the outcome.


RESULTS
The 98 patients who met the criteria included 44 males and 54 females with a mean (SD) age of 41.3 (18.5) years and range of 14 to 85 years. The most frequent diagnostic etiology was infectious in 32 (32.7%). Seventeen (17.3%) patients were undiagnosed or had true FUO. Of 9 patients followed up, 8 recovered and 1 expired. The mean duration of follow-up was 20.6 months (range, 0-168 months).


CONCLUSIONS
Infectious diseases, especially TB, continue to be the leading etiology of FUO in our area. Our data did not identify any predictor of certain FUO diagnoses except for older age and neoplastic etiology. True FUO patients generally did well. Reporting local experience is important in guiding clinicians about the epidemiologic patterns of FUO in their regions.
Moawad
Mahmoud A
MA
Section of Internal Medicine, King Faisal Specialists Hospital and Research Centre, Riyadh, Saudi Arabia. mahmoud_moawad@vmed.com
Bassil
Habib
H
Elsherif
Mona
M
Ibrahim
Abeer
A
Elnaggar
Moustafa
M
Edathodu
Jameela
J
Alharthi
Abdulaziz
A
Albugami
Muneerah
M
Sabry
Ahmed
A
Shoukri
Mohammed
M
Bakhsh
Ibtisam
I
Laudon
Ulrike
U
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003141:Communicable Diseases / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult