title: Fever of unknown origin: a clinical approach.
abstract: Fevers of unknown origin remain one of the most difficult diagnostic challenges in medicine. Because fever of unknown origin may be caused by over 200 malignant/neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders, clinicians often order non-clue-based imaging and specific testing early in the fever of unknown origin work-up, which may be inefficient/misleading. Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach. Characteristic history and physical examination findings together with key nonspecific test abnormalities are the basis for a focused clue-directed fever of unknown origin work-up.
authors.affiliation: Infectious Disease Division, Winthrop-University Hospital, Mineola, NY; State University of New York, School of Medicine, Stony Brook. Electronic address: bacunha@winthrop.org.
authors.forename: Burke A
authors.initials: BA
authors.lastname: Cunha
authors.affiliation: Hôpital Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Paris, France; Université Paris Descartes, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.affiliation: Infectious Disease Division, Rhode Island Hospital and The Miriam Hospital, Providence, RI; Brown University Alpert School of Medicine, Providence, RI.
authors.forename: Cheston B
authors.initials: CB
authors.lastname: Cunha
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods*; D003937:Diagnosis, Differential; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D008487:Medical History Taking; D010808:Physical Examination; D019564:Unnecessary Procedures
keywords: Adult fevers of unknown origin; Fevers of unknown origin; Focused diagnostic approach