Tijdschrift voor Geneeskunde vol:68 issue:17 pages:841-845
Fever of unknown origin: 40 years of research in the University Hospital of Leuven
Fever of unknown origin (FUO) is currently defined as an illness of more than three weeks characterized by a high fever or a fever with an acute phase response and an uncertain diagnosis after a careful baseline investigation. Numerous disorders belonging to diverse sub specialties can present as such.
When dealing with FUO, lessons from the past are still pertinent. Thus, the âbig threeâ diagnostic categories (not only infection, but also malignancy and sterile inflammation) should be kept in mind, pursuing all potential diagnostic clues.
In the search for a diagnosis behind FUO, atypical presentations of common diseases predominate over esoteric disorders. Thus, the threshold for taking samples for microbiological an pathological analyses should be kept low. Minimal invasive techniques are an asset. If the diagnosis remains uncertain, [(18F]fluoro-deoxyglucose positron emission tomography (FDG-PETÂ° can be helpful. After a negative and careful evaluation, a watchful waiting approach can be adopted in selected patients in sable general health.