Clinical spectrum and diagnostic tools of fever of unknown origin among hospitalized patients in Razi Hospital (2006-2008), Ahvaz

Introduction and objective: Fever of unknown origin (FUO) is still an important problem in clinical practice and is a challenging problem worldwide. The objective was to define the clinical spectrum, categories of the diseases and diagnostic tools.

Materials and methods: This retrospective study was undertaken from 2006 to 2008. All patients fulfilling the modified criteria for FUO, hospitalized in infectious disease ward of Razi Hospital in Ahvaz, were enrolled for analysis. Extracted data of patient's medical files including variables such as final diagnosis, diagnostic tools, and ESR values were analyzed in SPSS 11.5.

Results: The etiology of FUO was infectious diseases in 48.9% of the patients, collagen-vascular diseases in 17.8%, neoplasm in 8.3% and miscellaneous diseases in 8.3%. In 16.7% of the cases, the etiology could not be found. The two leading diseases were extra pulmonary tuberculosis (29.3%) and osteomyelitis (26.9%). Culturing, biopsy and CT-scan with the frequency of 31%, 16.7%, and 19.5% respectively were the frequent diagnostic tools. ESR with more than 50mm/h was associated with higher rate of serious disease.

Conclusion: In conclusion, tuberculosis was still the most important cause of FUO in our study. Culturing, biopsy and CT-scan were appropriate diagnostic tools. ESR with high value is a clue to the existence of a serious disease.