title: Problem based review: The patient with a pyrexia of unknown origin.
abstract: Pyrexia of unknown origin (PUO) is a frequent presentation to the Acute Medical Unit, and is a source of significant morbidity, both the psychological burden of an uncertain diagnosis and prognosis and untreated complications of the underlying pathology. We present a problem based review of the management of PUO, illustrated by a patient who recently presented to our unit with fever and systemic malaise after returning from abroad and in whom no cause could be found for more than two months. We describe a structured approach making use of complex modern techniques such as Positron Emission Tomography-Computed Tomography (PET-CT) which ultimately provided the diagnosis for our patient.
authors.affiliation: akwoolley@googlemail.com
authors.forename: Angharad K
authors.initials: AK
authors.lastname: Woolley
authors.forename: Neil A
authors.initials: NA
authors.lastname: Hedger
authors.forename: Rithesh P
authors.initials: RP
authors.lastname: Veettil
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001011:Aorta / Q000000981:diagnostic imaging; D001027:Aortography / Q000379:methods; D018771:Arthralgia / Q000209:etiology; D001241:Aspirin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006261:Headache / Q000209:etiology; D006801:Humans; D064747:Lansoprazole; D008296:Malaysia; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography; D011239:Prednisolone / Q000627:therapeutic use; D012846:Singapore; D013625:Takayasu Arteritis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D064747:Lansoprazole; D011239:Prednisolone; D001241:Aspirin