FEVER of UNKNOWN ORIGIN(FUO)<br />
Introduction<br />Normal body temperature 36,1 -37,8°C <br />Fever is defined as the elevation of core body temperature ab...
Definition<br />Petersdorf and Beeson as the following: a temperature greater than 38°C (101°F), more than 3 weeks duratio...
Etiology<br />infections (30-50%), <br />Neoplastic (5-30%), <br />Collagen vascular diseases (10-20%), <br />Miscellaneou...
DIAGNOSTIC APPROACH<br />In general, children with FUO clearly not suffering from a rare disease, but common diseases that...
DIAGNOSTIC APPROACH<br />Berhman<br />The first stage, anamnesis, physical examination and certain laboratory. After it is...
History<br />Age<br />Symptoms & Fever Type<br />Epydemiology History :<br />A history of exposure to wild or domestic ani...
PHYSICAL EXAMINATION<br />Definitive documentation of fever.Measure the fever more than once to exclude manipulation of th...
LABORATORY<br />Complete blood cell count with a differential WBC, urinalysis, Erythrocyte sedimentation rate (ESR), C-rea...
Treatment<br />Antimicrobial agents should not be used as antipyretics.<br />Empirical trials of medication should general...
PROGNOSIS<br />Children with FUO have a better prognosis than do adults.<br />The outcome in a child is dependent on the p...
THANK YOU FOR YOUR ATTENTION<br />
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Fever of unknown origin

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Fever of unknown origin

  1. 1. FEVER of UNKNOWN ORIGIN(FUO)<br />
  2. 2. Introduction<br />Normal body temperature 36,1 -37,8°C <br />Fever is defined as the elevation of core body temperature above normal, > 37,8°C orally or 38°C rectally.<br />Normal diurnal variation  maximum temperature in the late afternoon<br />
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  4. 4. Definition<br />Petersdorf and Beeson as the following: a temperature greater than 38°C (101°F), more than 3 weeks duration of illness, and failure to reach a diagnosis despite one week of inpatient investigation<br />
  5. 5. Etiology<br />infections (30-50%), <br />Neoplastic (5-30%), <br />Collagen vascular diseases (10-20%), <br />Miscellaneous diseases (15-20%)<br />
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  8. 8. DIAGNOSTIC APPROACH<br />In general, children with FUO clearly not suffering from a rare disease, but common diseases that have common clinical manifestation of a-tipically (not typical, not unusual)<br />Infectious diseases and vascular diseases - collagen (not neoplastic) is the largest cause of FUO.<br />Children with FUO have a better prognosis than adults.<br />In children FUO, continuous patient observation and repetition anamnesis and physical examination is often helpful<br />Keep in mind the possibility of fever caused by medications (drug fever).<br />
  9. 9. DIAGNOSTIC APPROACH<br />Berhman<br />The first stage, anamnesis, physical examination and certain laboratory. After it is evaluated to determine whether there are specific signs and symptoms or not.<br />The second phase, can be divided into 2 possibilities, namely:<br /> A. If signs and symptoms found in a particular focal additional checks then carried out a more specific diseases leading to the suspect.<br /> B. If there is no focal signs and symptoms, then do a complete re-examination of blood<br /> A and B then evaluated to proceed to stage three<br />The third phase, consisting of a more complex examination and directed, to other parts of the consultation and invasive acts performed as needed.<br />
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  11. 11. History<br />Age<br />Symptoms & Fever Type<br />Epydemiology History :<br />A history of exposure to wild or domestic animals . <br />A history of travel<br />Medication history<br />The genetic background<br />
  12. 12. PHYSICAL EXAMINATION<br />Definitive documentation of fever.Measure the fever more than once to exclude manipulation of thermometers.<br />Repeat a regular physical examination daily while the patient is hospitalized. <br />Pay special attention to rashes, cardiac murmurs, signs of arthritis, abdominal tenderness or rigidity, lymph node enlargement, funduscopic changes, and neurologic deficits.<br />
  13. 13. LABORATORY<br />Complete blood cell count with a differential WBC, urinalysis, Erythrocyte sedimentation rate (ESR), C-reactive protein<br />Radiographic examination<br />Examination of the bone marrow<br />Radionuclide scans<br />Total body CT or MRI<br />Biopsy<br />
  14. 14. Treatment<br />Antimicrobial agents should not be used as antipyretics.<br />Empirical trials of medication should generally be avoided.<br /> An exception may be the use of antituberculous treatment in critically ill children with suspected disseminated tuberculosis. <br />Empirical trials of other antimicrobial agents may be dangerous and can obscure the diagnosis of infective endocarditis, meningitis, parameningeal infection, or osteomyelitis. <br />After a complete evaluation, antipyretics may be indicated to control fever and for symptomatic relief .<br />
  15. 15. PROGNOSIS<br />Children with FUO have a better prognosis than do adults.<br />The outcome in a child is dependent on the primary disease process, which is usually an atypical presentation of a common childhood illness. <br />In many cases, no diagnosis can be established and fever abates spontaneously. <br />In as many as 25% of cases in which fever persists, the cause of the fever remains unclear, even after thorough evaluation.<br />
  16. 16. THANK YOU FOR YOUR ATTENTION<br />

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