AJCI, Cilt 1, Sayı 2 (2007)

Fever of Unknown Origin - Are There Predictors of Outcome: A Multicenter Study

Yaşar KÜÇÜKARDALI, Oral ÖNCÜL, Erdoğan KUNTER, Emrullah SOLMAZGÜL, Vedat TURHAN, Şaban ÇAVUŞLU, Mehmet DANACI, Semra ÇALANGU, Zuhal ADIBELLİ, Murat AKOVA, Engin AZAK, Melih Ahmet ÖZEL, Zahit BOLAMAN, Bülent SAKA, Namık ÖZMEN, Birsen ÇETİN, Erkan ÇOBAN, Hakan ERDEM, Oğuz KARABAY, Çağla KARAKOÇ, Akif KARAN, Selda KORKMAZ, Gülşen ÖZKAYA ŞAHİN, Alaattin PAHSA, Fatma SIRMATEL, İlyas TOKATLI, Cengiz UZUN, Ayşe Wilke TOPÇU, Gülşen YAKUPOĞLU, Bülent BEŞİRBELLİOĞLU

Özet


B AC K G R O U N D This study aimed to find out predictors of severe outcome and contributions of different methods to diagnosis in fever of unknown origin (F U O). M ET H O D S Consecutive 154 patients, 83 males and 71 females ( mean age 42±17), who met the modified Pedersdorf criteria for FUO, were enrolled. Death, malignancy, severe infection, and weight loss >10%, were considered as severe disease (SD) outcome and other outcomes referred to non-severe disease (NSD). R E S U LT S Fifty-three (34.4%) patients had infections, 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.2%) had malignant diseases, and 8 (5.2%) had miscellaneous diseases. In 15.6% (24 cases) of the cases, the etiology remained obscure. Sixty three (40%) of the cases had SD (22 malignant, 19 infectious, 12 NIID, 7 undiagnosed, 3 miscellaneous diseases) and 91 (60%) had NSD. None of the clinical symptoms was related to outcome severity. Low hemoglobin levels, elevated leukocyte counts and increased C-reactive protein levels indicated SD with univariate analysis (p<0.05). However, none of the parameters was independent predictor of severe outcome. Rates of positivity and contribution to diagnosis of the methods were; chemical techniques (36%-1.6%), biopsy (30%-95%), i m m u n o l o g i ca l serology (13%-40%), microbiologica l serology (4%-50%), imaging techniques (30%-23%) and culture techniques (5%-42%), respectively. CO N C L U S I O N S In FUO presence of the anemia, leukocytosis and increased CRP levels may be signs of possible severe outcome.

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