Pyrexia of Unknown Origin: Current Perspectives

  • Ekram Wassim Abdelwahab Tropical Health Department, High Institute of Public Health, Alexandria University


Pyrexia of unknown origin (PUO) is a grouping of many unrelated medical conditions that share the feature of persistent unexplained fever that does not resolve spontaneously within the period for self-limited infections and whose cause can not be ascertained despite adequate basic investigation and considerable diagnostic effort. PUOis a syndrome that has long tested the skills of physicians to achieve a diagnosis in affected patients.Patients included in this syndrome will be more difficult to diagnose as they have already resisted classification during baseline investigations. temporal and geographical distribution of PUO cases since 1950s through 2000s revealed shift in relative proportion of specific disease categories over decades. so far, there is no standardized approach for PUO diagnosis.evolving knowledge and the improvement in diagnostic methods, including new microbiological techniques and new instrumental procedures, necessitate a constant update of the tests included in a minimal diagnostic workup to qualify a fever as PUO.


Download data is not yet available.


Beresford RW, Gosbell IB. Pyrexia of unknown origin: causes, investigation and management. Intern Med J. 2016;46(9):1011-6.

Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine. 1961;40(1):1.

Larson EB, Featherstone HJ, Petersdorf RG. Fever of undetermined origin: diagnosis and follow-up of 105 cases, 1970-1980. Medicine (Baltimore). 1982; 61(5):269-92.

Durack D, Street A. Fever of unknown origin--reexamined and redefined. Current clinical topics in infectious diseases. 1991;11:35-51.

Kumar P, Kumar A, Rajeshwari K, Neeharika D, Sindhu G, Sreevidya B. Fever of unknown origin (FUO): evolution of case definition, changing aetiological spectrum. Clin Sci Res. 2016;5:33-9.

Gaeta GB, Fusco FM, Nardiello S. Fever of unknown origin: a systematic review of the literature for 1995-2004. Nuclear medicine communications. 2006;27(3): 205.

Horowitz HW. Fever of unknown origin or fever of too many origins? N Engl J Med. 2013;368(3):197-9.

Chow A, Robinson JL. Fever of unknown origin in children: a systematic review. World J Pediatr. 2011; 7(1):5-10.

Efstathiou SP, Pefanis AV, Tsiakou AG, Skeva, II, Tsioulos DI, Achimastos AD, et al. Fever of unknown origin: discrimination between infectious and non-infectious causes. Eur J Intern Med. 2010; 21(2):137-43.

Bleeker-Rovers CP, Vos FJ, de Kleijn EMHA, Mudde AH, Dofferhoff TSM, Richter C, et al. A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine. 2007;86(1):26.

Dua J, Cheung W, Russell S. An unusual cause of fever of unknown origin. BMJ. 2011;342.

Knockaert DC, Vanneste LJ, Bobbaers HJ. Fever of unknown origin in elderly patients. J Am Geriatr Soc. 1993;41(11):1187-92.

Mansueto P, Di Lorenzo G, Rizzo M, Di Rosa S, Vitale G, Rini G, et al. Fever of unknown origin in a Mediterranean survey from a division of internal medicine: report of 91 cases during a 12-year-period (1991-2002). Intern Emerg Med. 2008; 3(3):219-25.

Zenone T. Fever of unknown origin in adults: evaluation of 144 cases in a non-university hospital. Scandinavian Journal of infectious diseases. 2006; 38(8):632-8.

Hot A, Jaisson I, Girard C, French M, Durand DV, Rousset H, et al. Yield of bone marrow examination in diagnosing the source of fever of unknown origin. Arch Intern Med. 2009;169(21):2018-23.

Vanderschueren S, Eyckmans T, De Munter P, Knockaert D. Mortality in patients presenting with fever of unknown origin. Acta Clin Belg. 2014; 69(1):12-6.

Sandoval C, Pinochet C, Pena A, Rabello M, Prado A, Viviani T. [Fever of unknown origin: a challenge for the pediatric infectious diseases specialist]. Rev Chilena Infectol. 2014; 31(1):87-91.

Pedersen TI, Roed C, Knudsen LS, Loft A, Skinhoj P, Nielsen SD. Fever of unknown origin: a retrospective study of 52 cases with evaluation of the diagnostic utility of FDG-PET/CT. Scand J Infect Dis. 2012; 44(1):18-23.

Iwanczak B, Pytrus T, Stawarski A, Mowszet K, Iwanczak F. [Management of fever without source in children]. Przegl Lek. 2007;64 Suppl 3:20-4.

Bakashvili LZ, Makhviladze MA, Pagava EK, Pagava KI. [Fever of Unknown Origin in children and adolescents in Georgia: a review of 52 patients]. Georgian Med News. 2006; (135):66-9.

Kim YS, Kim KR, Kang JM, Kim JM, Kim YJ. Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center. Korean J Pediatr. 2017;60(3):77-85.

Kasai K, Mori M, Hara R, Miyamae T, Imagawa T, Yokota S. National survey of childhood febrile illness cases with fever of unknown origin in Japan. Pediatr Int. 2011;53(4):421-5.

Naito T, Mizooka M, Mitsumoto F, Kanazawa K, Torikai K, Ohno S, et al. Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study. BMJ Open. 2013;3(12):e003971.

Chin C, Chen YS, Lee SSJ, Wann SR, Lin HH, Lin WR, et al. Fever of unknown origin in Taiwan. Infection. 2006;34(2):75-80.

Cho CY, Lai CC, Lee ML, Hsu CL, Chen CJ, Chang LY, et al. Clinical analysis of fever of unknown origin in children: A 10-year experience in a northern Taiwan medical center. J Microbiol Immunol Infect. 2017; 50(1):40-5.

Chien YL, Huang FL, Huang CM, Chen PY. Clinical approach to fever of unknown origin in children. J Microbiol Immunol Infect. 2015 Oct 09.

Zhiyong Z, Bingjun L, Xiaoju L, Xinjian F, Ping F, Wenya W. Fever of unknown origin: a report from China of 208 cases. International Journal of Clinical Practice. 2003; 57(7):592.

Hu Z, Yang Q, Zheng S, Tang J, Lu W, Xu N, et al. Temporal arteritis and fever: report of a case and a clinical reanalysis of 360 cases. Angiology. 2000; 51(11):953-8.

Joshi N, Rajeshwari K, Dubey AP, Singh T, Kaur R. Clinical spectrum of fever of unknown origin among Indian children. Ann Trop Paediatr. 2008; 28(4): 261-6.

Bandyopadhyay D, Bandyopadhyay R, Paul R, Roy D. Etiological study of fever of unknown origin in patients admitted to medicine ward of a teaching hospital of Eastern India. Journal of Global Infectious Diseases. 2011; 3(4): 329.

Shantaram V, Amvr N, . A. Approach to the Patient with fever of unknown origin. In: Muruganathan A, editor. Medicine update. New Delhi: Jaypee Brothers Medical Publishers (for The Association of Physicians of India); 2013. p. 44-7. Available at URL:

Mir T, Nabi Dhobi G, Nabi Koul A, Saleh T. Clinical profile of classical Fever of unknown origin (FUO). Caspian J Intern Med. 2014;5(1): 35-9.

Ikhlas A, Ahmad QI, Asif A, Waseem I, Ahmad TM, TZ M. ever of unknown origin in children: a challenge persisting with advancing medical care. J Pediatr Infect Dis. 2014;9(19):19-22.

Saltoglu N, Tasova Y, Midikli D, Aksu HS, Sanli A, Dundar IH. Fever of unknown origin in Turkey: evaluation of 87 cases during a nine-year-period of study. J Infect. 2004; 48(1): 81-5.

Kucukardali Y, Oncul O, Cavuslu S, Danaci M, Calangu S, Erdem H, et al. The spectrum of diseases causing fever of unknown origin in Turkey: a multicenter study. International Journal of Infectious Diseases. 2008; 12(1): 71-9.

Colpan A, Onguru P, Erbay A, Akinci E, Cevik MA, Eren SS, et al. Fever of unknown origin: analysis of 71 consecutive cases. Am J Med Sci. 2007; 334(2): 92-6.

Cogulu O, Koturoglu G, Kurugol Z, Ozkinay F, Vardar F, Ozkinay C. Evaluation of 80 children with prolonged fever. Pediatr Int. 2003;45(5): 564-9.

Ciftci E, Ince E, Dogru U. Pyrexia of unknown origin in children: a review of 102 patients from Turkey. Ann Trop Paediatr. 2003; 23(4): 259-63.

Tezer H, Ceyhan M, Kara A, Cengiz AB, Devrim I, Secmeer G. Fever of unknown origin in children: the experience of one center in Turkey. Turk J Pediatr. 2012; 54(6): 583-9.

Mete B, Vanli E, Yemisen M, Balkan, II, Dagtekin H, Ozaras R, et al. The role of invasive and non-invasive procedures in diagnosing fever of unknown origin. Int J Med Sci. 2012; 9(8): 682-9.

Mahmoudi S, Mehrazmay A, Salesi M, Mamishi S. Fever of unknown origin: a retrospective study of 95 children in an Iranian referral hospital. Br J Biomed Sci. 2014; 71(1): 40-2.

Solimani G, Shafigji Shahri E, Salari Z, Shahrakipoor M, Teimouri A. Fever of unknown origin in children aged three months to fifteen years. Int J Infect. 2015; 2: e22906.

Abdelbaky MS, Mansour HE, Ibrahim SI, Hassan IA. Prevalence of Connective Tissue Diseases in Egyptian Patients Presenting with Fever of Unknown Origin. Clinical Medicine Insights Arthritis and Musculoskeletal Disorders. 2011; 4: 33.

Hassan RH, Fouda AE, Kandil SM. Fever of Unknown Origin in Children: A 6 year- Experience in a Tertiary Pediatric Egyptian Hospital. Int J Health Sci (Qassim). 2014; 8(1):13-9.

Ali-Eldin FA, Abdelhakam SM, Ali-Eldin ZA. Clinical spectrum of fever of unknown origin among adult Egyptian patients admitted to Ain Shams University Hospitals: a hospital based study. Journal of the Egyptian Society of Parasitology. 2011; 41(2): 379.

Montasser MF, Abdelkader NA, Montasser IF, El Khouly AM. Changing the face of fever of unknown origin in Egypt: a single hospital study. Braz J Infect Dis. 2015;19(3): 334-5.

Kabapy AF, Kotkat AM, Shatat HZ, Abd El Wahab EW. Clinico-epidemiological profile of fever of unknown origin in an Egyptian setting: A hospital-based study (2009-2010). J Infect Dev Ctries. 2016;10(1): 30-42.

Tabak F, Mert A, Celik A, Ozaras R, Altiparmak M, Ozturk R, et al. Fever of unknown origin in Turkey. Infection. 2003; 31(6): 417-20.

Mulders-Manders C, Simon A, Bleeker-Rovers C. Fever of unknown origin. Clin Med (Lond). 2015;15(3): 280-4.

Bleeker-Rovers CP, Van Der Meer JW, Oyen WJ. Fever of unknown origin Fever of Unknown Origin. Seminars in Nuclear Medicine. 2009; 39(2): 81-7.

Frank U, Tacconelli E. Fever of Unknown Origin: Differential Diagnosis. The Daschner Guide to: In-Hospital Antibiotic Therapy. 2012: 238-45.

de Kleijn EMHA, Vandenbroucke JP, van der Meer JWM. Fever of unknown origin (FUO): I. A prospective multicenter study of 167 patients with FUO, using fixed epidemiologic entry criteria. Medicine. 1997; 76(6): 392.

Cunha BA. Fever of unknown origin: focused diagnostic approach based on clinical clues from the history, physical examination, and laboratory tests. Infectious Disease Clinics of North America. 2007; 21(4): 1137-87.

Jitendranath L, Slim JW. Work-up of fever of unknown origin in adult patients. Hosp Phys. 2005; 41: 9–15.

Hayakawa K, Ramasamy B, Chandrasekar PH. Fever of Unknown Origin: An Evidence-Based Review. The American Journal of the Medical Sciences. 2012.

Robine A, Hot A, Maucort-Boulch D, Iwaz J, Broussolle C, Seve P. Fever of unknown origin in the 2000s: evaluation of 103 cases over eleven years. Presse Med. 2014; 43(9): e233-40.

Tolan RW. Fever of unknown origin: a diagnostic approach to this vexing problem. Clinical pediatrics. 2010; 49(3):207-13.

Liu CP, Liu ZY, Liu JP, Kang Y, Mao CS, Shang J. Diagnostic Value of Common Inflammatory Markers on Fever of Unknown Origin. Jpn J Infect Dis. 2016; 69(5): 378-83.

Yu KK, Chen SS, Ling QX, Huang C, Zheng JM, Cheng Q, et al. Fever of unknown origin: report of 107 cases in a university hospital. Int J Clin Exp Med. 2014;7(12):5862-6.

Moawad MA, Bassil H, Elsherif M, Ibrahim A, Elnaggar M, Edathodu J, et al. Fever of unknown origin: 98 cases from Saudi Arabia. Annals of Saudi Medicine. 2010; 30(4): 289.

Al-Tonbary YA, Soliman OE, Sarhan MM, Hegazi MA, El-Ashry RA, El-Sharkawy AA, et al. Nosocomial infections and fever of unknown origin in pediatric hematology/oncology unit: a retrospective annual study. World Journal of Pediatrics. 2011;7(1): 60-4.

Finkelstein JA, Christiansen CL, Platt R. Fever in pediatric primary care: occurrence, management, and outcomes. Pediatrics. 2000;105(1 Pt 3): 260-6.

Antoon JW, Potisek NM, Lohr JA. Pediatric Fever of Unknown Origin. Pediatr Rev. 2015; 36(9): 380-90; quiz 91.

Pasic S, Minic A, Djuric P, Micic D, Kuzmanovic M, Sarjanovic L, et al. Fever of unknown origin in 185 paediatric patients: a single-centre experience. Acta Paediatr. 2006 Apr; 95(4): 463-6.

Akpede GO, Akenzua GI. Management of children with prolonged fever of unknown origin and difficulties in the management of fever of unknown origin in children in developing countries. Paediatr Drugs. 2001; 3(4): 247-62.

Shi XC, Liu XQ, Zhou BT, Zhang LF, Ma XJ, Deng GH, et al. Major causes of fever of unknown origin at Peking Union Medical College Hospital in the past 26 years. Chin Med J (Engl). 2013;126(5): 808-12.

Lachmann HJ. Autoinflammatory syndromes as causes of fever of unknown origin. Clin Med (Lond). 2015;15(3): 295-8.

Williams J, Bellamy R. Fever of unknown origin. Clin Med (Lond). 2008;8(5):526-30.

Leong S, Karkos P, Apostolidou M. Is there a role for the otolaryngologist in PFAPA syndrome?: A systematic review. International Journal of Pediatric Otorhinolaryngology. 2006; 70(11): 1841-5.

Ciftdogan DY, Bayram N, Vardar F. Brucellosis as a Cause of Fever of Unknown Origin in Children Admitted to a Tertiary Hospital in the Aegean Region of Turkey. Vector-Borne and Zoonotic Diseases. 2011.

Park HS, Im SJ, SE P. Investigation of causes of FUO (fever of unknown origin) in children. Korean J Pediatr 2006; 49: 1282-6.

Cagatay AA, Tufan F, Hindilerden F, Aydin S, Elcioglu OC, Karadeniz A, et al. The Causes of Acute Fever Requiring Hospitalization in Geriatric Patients: Comparison of Infectious and Noninfectious Etiology. Journal of aging research. 2010; 2010.

Turkulov V, Brkic S, Sevic S, Maric D, Tomic S. Fever of unknown origin in elderly patients. Srp Arh Celok Lek. 2011;139(1-2):64-8.

Onal IK, Cankurtaran M, Cakar M, Halil M, Ulger Z, Dogu BB, et al. Fever of unknown origin: what is remarkable in the elderly in a developing country? J Infect. 2006; 52(6): 399-404.

Chen Y, Zheng M, Hu X, Li Y, Zeng Y, Gu D. Fever of unknown origin in elderly people: a retrospective study of 87 patients in China. J Am Geriatr Soc. 2008; 56(1):182-4.

Maharaj D. Fever in Pregnancy. 2017. Available at:

Gilbert GL. 1: Infections in pregnant women. Med J Aust. 2002 Mar 04;176(5):229-36.

Lee WL, Chiu LM, Wang PH, Chao HT, Yuan CC, Ng HT. Fever of unknown origin in the puerperium. A case report. J Reprod Med. 1998; 43(2):149-52.

Milne K, Dallard T, Douglas JG. Fever of unknown origin in pregnancy: the need for a full history. BMJ Case Rep. 2012;2012.

Poespoprodjo JR, Fobia W, Kenangalem E, Lampah DA, Warikar N, Seal A, et al. Adverse pregnancy outcomes in an area where multidrug-resistant plasmodium vivax and Plasmodium falciparum infections are endemic. Clin Infect Dis. 2008; 46(9): 1374-81.

Avkan-Oguz V, Yapar N, Ozakbas S, Demir-Onder K, Aktas E, Alp-Cavus S, et al. A case of fever of unknown origin: co-existence of Kikuchi-Fujimoto disease and acute disseminated encephalomyelitis (ADEM). Intern Med. 2010; 49(16): 1823-6.

Mathews D, McMahon P, Bolton M. Unusual Cause of Prolonged Fever of Unknown Origin. Clinical Pediatrics. 2017:1-3.

Deaver D, Horna P, Cualing H, Sokol L. Pathogenesis, diagnosis, and management of Kikuchi-Fujimoto disease. Cancer Control. 2014; 21(4): 313-21.

Cunha BA, Mickail N, Durie N, Pherez FM, Strollo S. Fever of unknown origin (FUO) caused by Kikuchi's disease mimicking lymphoma. Heart Lung. 2009; 38(5): 450-6.

Cunha BA, Bouyarden M, Hamid NS. Fever of unknown origin (FUO) caused by multiple myeloma: the diagnostic value of the Naprosyn test. Heart Lung. 2006; 35(5): 358-62.

Simon A, Cuisset L, Vincent MF, van Der Velde-Visser SD, Delpech M, van Der Meer JW, et al. Molecular analysis of the mevalonate kinase gene in a cohort of patients with the hyper-igd and periodic fever syndrome: its application as a diagnostic tool. Ann Intern Med. 2001;135(5): 338-43.

Speil C, Mushtaq A, Adamski A, Khardori N. Fever of unknown origin in the returning traveler. Infect Dis Clin North Am. 2007; 21(4):1091-113.

Wilson ME, Weld LH, Boggild A. GeoSentinel Surveillance Network. Fever in returned travelers: results from GeoSentinel surveillance network. Clin Infect Dis. 2007; 44:1560–8.

Bottieau E, Clerinx J, Schrooten W, Van den Enden E, Wouters R, Van Esbroeck M, et al. Etiology and outcome of fever after a stay in the tropics. Arch Intern Med. 2006; 166(15): 1642-8.

Stienlauf S, Segal G, Sidi Y, Schwartz E. Epidemiology of travel-related hospitalization. J Travel Med. 2005; 12(3): 136-41.

Boggild AK, Geduld J, Libman M. Travel-acquired infections and illnesses in Canadians: surveillance report from CanTravNet surveillance data, 2009–2011. Open Med. 2014; 8: e20–e32.

Korzeniewski K, Gawel B, Krankowska D, Wasilczuk K. Fever of unknown origin in returning travellers. Int Marit Health. 2015; 66(2): 77-83.

Lourenco SC, Baptista A, Pacheco H, Malhado J. A misplaced surgical towel - a rare cause of fever of unknown origin. Eur J Intern Med. 2008; 19(5): 377-8.

Sarwari AR, Mackowiak PA. Factitious fever: a modern update. Curr Clin Top Infect Dis. 1997; 17: 88-94.

Quereshi H. Factitious fever. J Pak Med Assoc. 1983 Aug;33(8):189-91.

Cleri DJ, Ricketti AJ, Vernaleo JR. Fever of unknown origin due to zoonoses. Infect Dis Clin North Am. 2007; 21(4):963-96, viii-ix.

WHO-ONT. lobal Observatory on Donation and Transplantation. 2016. Available at, Accessed: February 10, 2017.

Camargo JF. Donor-derived infections in solid organ transplant recipients: Challenging the 30-day paradigm. Transpl Infect Dis. 2017; 19(2).

Grossi PA, Fishman JA. Donor-derived infections in solid organ transplant recipients. Am J Transplant. 2009; 9 Supp l 4: S19-26. Accessed: December 31, 2014. AJoTSITASoTIDGrEWOLAa.

Bouza E, Loeches B, Munoz P. Fever of unknown origin in solid organ transplant recipients. Infect Dis Clin North Am. 2007; 21(4):1033-54, ix-x.

Armstrong WS, Katz JT, Kazanjian PH. Human immunodeficiency virus—associated fever of unknown origin: a study of 70 patients in the United States and review. Clinical infectious diseases. 1999; 28(2): 341-5.

Hot A, Schmulewitz L, Viard JP, Lortholary O. Fever of unknown origin in HIV/AIDS patients. Infect Dis Clin North Am. 2007; 21(4):1013-32, ix.

Chandrasekhar A, Gupta A. Nutrition and disease progression pre–highly active antiretroviral therapy (HAART) and post-HAART: can good nutrition delay time to HAART and affect response to HAART? The American Journal of Clinical Nutrition. 2011; 94(6): 1703S-15S.

Gompels M, Dunn DT, Phillips A, Dooley D, Thomas ADB, Anderson J, et al. Does Discordancy Between the CD4 Count and CD4 Percentage in HIV-Positive Individuals Influence Outcomes on Highly Active Antiretroviral Therapy? Journal of Infectious Diseases. 2012; 205(4):540-7.

Lozano F, Torre-Cisneros J, Santos J, León E, Domínguez A, Montesdeoca M, et al. Impact of highly active antiretroviral therapy on fever of unknown origin in HIV-infected patients. European Journal of Clinical Microbiology & Infectious Diseases. 2002; 21(2): 137-9.

Weissman S, Golden MP, Jain S. FUO in HIV-positive patients in the era of HAART. Infections in medicine. 2004; 21(7): 335-40.

Hayakawa K, Ramasamy B, Chandrasekar PH. Fever of Unknown Origin: An Evidence-Based Review. The American Journal of the Medical Sciences. 2012; 344(4): 307-16.

Nafsi T, Lin MV, Stern J. Angiotropic lymphoma: A Concealed Etiology of Fever of Unknown Origin. European Journal of General Medicine. 2010; 7(2): 234-9.

Betts AM, Banks KP, Solberg AO. Unsuspected Perforated Richter Hernia in the Inguinal Canal Detected by F-18 FDG PET/CT. Clinical Nuclear Medicine. 2011; 36(12): 1118.

Bansal R, Hayman G, Bansal A. Fever of Unknown Origin: An Unusual Case. Case Reports in Infectious Diseases. 2011; 2011.

von Lilienfeld-Toal M, Lehmann LE, Raadts AD, Hahn-Ast C, Orlopp KS, Marklein G, et al. Utility of a commercially available multiplex real-time PCR assay to detect bacterial and fungal pathogens in febrile neutropenia. Journal of Clinical Microbiology. 2009; 47(8): 2405-10.

Schuppan D, Afdhal NH. Liver cirrhosis. The Lancet. 2008; 371(9615): 838-51.

Mölleken C, Sitek B, Henkel C, Poschmann G, Sipos B, Wiese S, et al. Detection of novel biomarkers of liver cirrhosis by proteomic analysis. Hepatology. 2009; 49(4): 1257-66.

Vanderschueren S, Del Biondo E, Ruttens D, Boxelaer IV, Wauters E, Knockaert DDC. Inflammation of unknown origin versus fever of unknown origin: two of a kind. European Journal of Internal Medicine. 2009; 20(4): 415-8.

Peck KR, Cheong HS, Kang CI, Lee JA, Moon SY, Joung MK, et al. Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis. Clinical Infectious Diseases. 2009; 48(9): 1230.

Liles WC, Dellinger EP. Peritonitis and intra-abdominal abscesses 2010.

Rajput V, Bromley SM. Familial Mediterranean fever. Lancet. 1998;351(9116):1658-9.

Bosch X, Pomares M. Familial Mediterranean fever. Lancet. 1998;351(9116):1658.

McDermott EM, Drenth JP, Powell RJ. Familial Mediterranean fever. Lancet. 1996; 348(9026):554-5.

Cunha BA, Hage JE, Nouri Y. Recurrent fever of unknown origin (FUO): aseptic meningitis, hepatosplenomegaly, pericarditis and a double quotidian fever due to juvenile rheumatoid arthritis (JRA). Heart Lung. 2012; 41(2): 177-80.

Tumulty PA. Topics in clinical medicine. The patient with fever of undetermined origin: A diagnostic challenge. The Johns Hopkins Medical Journal. 1967; 120(2): 95.

Antoon JW, Knudson-Johnson M, Lister WM. Diagnostic approach to fever of unknown origin. Clin Pediatr (Phila). 2012; 51(11): 1091-4.

Finch CA, Bellotti V, Stray S, Lipschitz DA, Cook JD, Pippard MJ, et al. Plasma ferritin determination as a diagnostic tool. West J Med. 1986; 145(5): 657-63.

Allen CE, Yu X, Kozinetz CA, McClain KL. Highly elevated ferritin levels and the diagnosis of hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer. 2008; 50(6): 1227-35.

Larsen G, Loghman-Adham M. Acute renal failure with hyperuricemia as initial presentation of leukemia in children. J Pediatr Hematol Oncol. 1996; 18(2): 191-4.

Freedberg KA, Malabanan A, Samet JH, Libman H. Initial assessment of patients infected with human immunodeficiency virus: the yield and cost of laboratory testing. J Acquir Immune Defic Syndr. 1994; 7(11): 1134-40.

Hersch EC, Oh RC. Prolonged febrile illness and fever of unknown origin in adults. Am Fam Physician. 2014; 90(2): 91-6.

Chang JC. How to differentiate neoplastic fever from infectious fever in patients with cancer: usefulness of the naproxen test. Heart Lung. 1987;16(2): 122-7.

Balink H, Collins J, Bruyn G, Gemmel F. F-18 FDG PET/CT in the diagnosis of fever of unknown origin. Clinical Nuclear Medicine. 2009; 34(12): 862.

Meller J, Sahlmann CO, Scheel AK. 18F-FDG PET and PET/CT in fever of unknown origin. Journal of Nuclear Medicine. 2007;48(1): 35-45.

Bleeker-Rovers CP, Vos FJ, Mudde AH, Dofferhoff ASM, de Geus-Oei LF, Rijnders AJ, et al. A prospective multi-centre study of the value of FDG-PET as part of a structured diagnostic protocol in patients with fever of unknown origin. European Journal of Nuclear Medicine and Molecular Imaging. 2007; 34(5): 694-703.

Aberg JA, Kaplan JE, Libman H, Emmanuel P, Anderson JR, Stone VE, et al. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV medicine Association of the Infectious Diseases Society of America. Clinical infectious diseases. 2009; 49(5): 651-81.

Varghese GM, Trowbridge P, Doherty T. Investigating and managing pyrexia of unknown origin in adults. BMJ. 2010; 341.

Hayreh SS. Clinical Features of Giant Cell Arteritis. Ischemic Optic Neuropathies. 2011:173-8.

Abstract : 0 | PDF : 0
How to Cite
Wassim Abdelwahab E. Pyrexia of Unknown Origin: Current Perspectives. IJBR [Internet]. 13Jan.2019 [cited 23Apr.2019];10(1):e4987. Available from:
Review Article