Fever of unknown origin - a multidisciplinary problem


I.G. Gordeev, V.N. Soboleva, N.A. Volov, Yu.M. Mashukova, E.E. Luchinkina

Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
The term «Fever of unknown origin» corresponds to a situation in clinical practice in which a long-lasting fever is the leading or the only sign of a disease that remains unrecognized during a routine examination. Difficulties in establishing the correct diagnosis are due to the presence of a large number of diseases occurring with a febrile syndrome, which are combined into four groups: generalized or local infectious and inflammatory processes, malignancy, systemic diseases (connective tissue diffuse diseases, vasculitis), other diseases (pathology of the intestine, endocrine organs, etc.). Such a variety of etiological factors dictates the participation in the diagnostic process of representatives of various medical professions - internists, cardiologists, rheumatologists, oncologists and, if necessary, other specialists. A clinical example illustrates the difficulty of diagnosing a disease that occurs with the syndrome of prolonged hyperthermia.
Keywords: West Nile fever, diagnostic algorithm, fever of unknown origin, etiology
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Literature

  • Дворецкий Л.И. Лихорадка неясного генеза. Вечная клиническая интрига // 2-е изд. М.: МЕДпресс-информ, 2017. 176 с. [Dvoretsky L.I. Fever of unknown origin. Eternal clinical intrigue // 2 ed. - M.: MEDPRESS-INFORM, 2017. - 176 p.]
  • Chow A., Robinson J.L. Fever of unknown origin in children: a systematic review. World J Pediatr. 2011;7(1):5-10.
  • Petersdorf R.G., Beeson Р. Fever of unknown origin. Medicine. 1961;40:1-30.
  • Дифференциальная диагностика и лечение внутренних болезней: Руководство для врачей.Вв 4 т. Под общ. ред. Ф.И. Комарова // Изд. 3-е, обновленное и дополненное. Т. 4. 2003. [Differential diagnosis and treatment of internal diseases: A guide for doctors. - in 4 volumes. Under the general editorship of F.I. Komarov. - Ed. 3rd, updated and supplemented. -V.4. 2003.]
  • FoggoV., Cavenagh J. Malignant causes of fever of unknown origin. Clinical Medicine. 2015;18:292-294.
  • Unger M., Karanicas G., Kerschbaumer A. et al. Fever of unknown origin ­(FUO) revised. Wien Klin Wochenschr. 2016;128(21):796-801.
  • Дерягин Ю.П., Юрьев А.Н., Зотина Г.П. Лихорадочный синдром в клинической практике. Дифференциальная диагностика // Изд.2-е. Красноярск. 2003. [Deryagin Yu.P., Yuriev A.N., Zotina G.P. Feverish syndrome in clinical practice. Differential diagnostics. 2 ed. Krasnoyarsk. 2003.]
  • Salzberger B., Birkenfeld G., Iberer M., Hitzenbichler F. Infektionen als Ursache für Fieber unklarer Genese. Dtsch Med Wochenschr. 2017;142(13):951-960.
  • Kazanjian P.H. FUO: review of 86 patients treated in community hospital. Clin Infect Dis. 1992;15 (6):968–974.
  • Knockaert D.P. Clinical value of gallium 67 in evaluation of FUO. Clin Infect Dis. 1994;18:601–605.
  • Hayakawa K., Ramasamy B., Chandrasekar P.H. Fever of unknown origin: an evidence-based review. Am J Med Sci. 2012;344(4):307-316.
  • Schafu Ch., Kirsh W. Unklares Fieber. Internist 1994;35(4):415-423.
  • Murgue В., Zeller H., Deubel V. The ecology and epidemiology of West Nile virus in Africa, Europe and Asia. Curr. Top. Microbiol. Immunol. 2002;267:195-221.
  • Lvov D.K., Butenko A.M., Gromashevsky V.L. et al. West Nile virus and other zoonotic viruses in Russia: examples of emerging-reemerging situations. Arch. Virol. 2004;18:85-96.
  • Карпов И.А., Качанко Е.Ф., Василенко А.А. и соавт. Энцефалиты в клинической практике – так ли все просто? // Клин микробиол антимикроб химиотер. 2011. № 2. С. 104–134. [Karpov I.A., Kachanko E.F., Vasilenko A.A. et al. Encephalitis in clinical practice - is it all that simple? Klin microbiol antimicrobial chemotherapeutic. 2011. № 2. P. 104–134.]
  • Венгеров Ю. Я., Платонов А. Е. Лихорадка Западного Нила. В кн.: Ющук Н. Д., Венгеров Ю. Я. (ред.). Лекции по инфекционным болезням // М.: Медицина; 2007. C. 873—882. [Vengerov Yu.Y., Platonov A.E. Fever of the West Nile. In the book: Y. Yushchuk, Yu.Y. Vengerov (ed.). Lectures on infectious diseases. M.: Medicine; 2007. 873–882.]
  • Kleinschmidt-DeMasters B.K, Beckham J.D. West Nile Virus Encephalitis 16 Years Later. Brain Pathol. 2015;25 (5):625-633.
  • Лобзин Ю.В., Белозеров Е.С., Беляева Т.В., Волжанин В.М. Вирусные болезни человека // СПб: СпецЛит., 2015. 400 с. [Lobzin Yu.V., Belozerov E.S., Belyaeva Т.V., Volzhanin V.М. Human viral diseases // St. Petersburg: SpetsLit., 2015. 400 p.]
  • Sambri V., Capobianchi M., Charrel R. et al. West Nile virus in Europe: emergence, epidemiology, diagnosis, treatment, and prevention. Clin Microbiol Infect. 2013;(8):699-704.
  • Львов Д.К. Лихорадка Западного Нила // Волгоград: Издатель., 2004. 104 с. [Lvov D.K. Fever of the West Nile // Volgograd: The Publisher., 2004. 104 p.]
  • Sejvar J.J. Clinical manifestations and outcomes of West Nile virus infection. Viruses. 2014;6(2):606-623.
  • Suthar M.S, Pulendran B. Systems analysis of West Nile virus infection. Curr Opin Virol. 2014;6:70-75.


    • About the Autors

    Ivan G. Gordeev, MD, Professor, Head of the Department of Hospital Therapy № 1, Pirogov Russian National Research Medical University of the Ministry of Health care of Russia. Аddress: 117997, Moscow, Ostrovityanova street, 1. E-mail: cardio-15@yandex.ru

    Valentina N. Soboleva, MD PhD, Associate Professor of the Department of Hospital Therapy № 1, Pirogov Russian National Research Medical University of the Ministry of Health care of Russia. Аddress: 117997, Moscow, Ostrovityanova street, 1. E-mail: vnsoboleva@yandex.ru

    Nikolai A. Volov, MD PhD, Associate Professor of the Department of Hospital Therapy № 1, Pirogov Russian National Research Medical University of the Ministry of Health care of Russia. Аddress: 117997, Moscow, Ostrovityanova street, 1. E-mail: drvolov@yandex.ru
    Yulia M. Mashukova, MD PhD, Associate Professor of the Department of Hospital Therapy № 1, Pirogov Russian National Research Medical University of the Ministry of Health care of Russia. Аddress: 117997, Moscow, Ostrovityanova street, 1. E-mail: alfilenko@rambler.ru

    Elena E. Luchinkina, MD PhD, Associate Professor of the Department of Hospital Therapy № 1, Pirogov Russian National Research Medical University of the Ministry of Health care of Russia. The address: 117997, Moscow, Ostrovityanova street, 1. E-mail: eluchinkina@gmail.com

    Sevinch S. Mamedguseyinova, Laboratory assistant of the Department of Hospital Therapy No. 1, Pirogov Russian National Research Medical University of the Ministry of Health care of Russia. The address: 117997, Moscow, Ostrovityanova street, 1. E-mail: audilovett@mail.ru

    Nina D. Lapochkina, Laboratory assistant of the Department of Hospital Therapy No. 1, Pirogov Russian National Research Medical University of the Ministry of Health care of Russia. The address: 117997, Moscow, Ostrovityanova street, 1.
    E-mail: n_lapochkina@bk.ru


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