The changing spectrum of diseases causing fever of unknown origin in Turkey: a multicentre study
Abstract number: 1134_04_43
Kucukardali Y., Oncul O., Cavuslu S., Danaci M., Calangu S.
The spectrum of diseases causing Fever of Unknown Origin (FUO) not only seems to be determined by geographical factors but also appears to change over time. To update information on FUO and incorporate these new ideas, we conducted a prospective multicentre study on patients with FUO in ten Turkish University Hospitals.
The present study was undertaken between January 2003 and June 2004. The Petersdorf criteria (illness characterized by rectal temperature exceeding 38.3°C, evolving least 3 weeks, with no diagnosis after one week of inpatient investigation). were used in diagnosis FUO. Patient demographics, etiology of FUO that could be detected, clinical symptoms and signs were recorded.
A total of 154 patients fulfilling the criteria of FUO were determined. Mean age was 42.95 ± 17.76 (1775) and 56.5% of the patients were males. A total of 154 immunocompetent patients with FUO were followed up of whom 53 (34.4%) had infections, 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.2%) had malignant diseases, 8 (5.2%) had miscelleneous diseases. In 15.6% (24) of the cases, the reason for high fever could not be explained despite every effort. The most common infectious etiologies were tuberculosis [20 (37.7%)] and brucellosis [8 (15.1%)]. On the contrary, Adult Still Disease was the most common NIID [22 (46.8%)], and haematologic malignancy was the most common malignant diseases [8 (36.4%)]. For the 130 patients with diagnosis, a diagnosis was established after a median of 32.12 ± 18.53 days from the onset of fever (range, 490). In patients with NIID, the median duration of reaching a diagnosis (37.76 ± 23.77) was significantly longer, compared with the patients with infection (25.56 ± 12.78) (p = 0.007). The median duration of fever in the group of 130 patients in whom a diagnosis was made was 35.95 ± 32.62 days (range, 3180). In patients with malignancy, the median duration of fever (51.38 ± 35.55) was longer, compared with the patients with infection (37.58 ± 38.97) (p = 0.052).
Several reports have been reported a changing pattern in the prevalence of the three main categories of the FUO in Turkey since 1985: infections, malignancies and NIIS. Our multicentre study showed that a decrease in the prevalence of infectious diseases in favor of the other two groups compared with the previous Turkish studies.
|Session name:||XXIst ISTH Congress|
|Back to top|