Vnitr Lek 2021, 67(1):e32-e42 | DOI: 10.36290/vnl.2021.015

Fever of unknown origin

Vyacheslav Grebenyuk^1,2, Olga Kryštůfková³, Monika Gregová³, Magdalena Sokalská‑Jurkiewicz³, Renata Steinbauerová⁴, Marie Sukovská⁴, Lubica Gahérová⁵, Ivana Zubatá⁵, Jana Gregorová⁶, Lucia Kaliská⁷, Hana Roháčová², Milan Trojánek^1,2,8

¹ Klinika infekčních nemocí, 2. lékařská fakulta, Univerzita Karlova, Praha

² Klinika infekčních, parazitárních a tropických nemocí, Fakultní nemocnice Bulovka, Praha

³ Revmatologický ústav, Praha

⁴ Oddělení klinické hematologie, Fakultní nemocnice Bulovka, Praha

⁵ Interní hematologická klinika, 3. lékařská fakulta a Fakultní nemocnice Královské Vinohrady, Praha

⁶ Oddělení klinické farmacie, Praha

⁷ Oddělení nukleární medicíny, Proton Therapy Center Czech, Praha

⁸ Katedra infekčního lékařství, IPVZ, Praha

Fever of unknown origin is a rare clinical syndrome, that represents a significant diagnostic challenge. There have been described more than 200 potential diseases, that can manifest as a fever of unknown origin. These are classically divided into following categories: infections, non-infectious inflammatory diseases, malignancies, and other miscellaneous disorders. Each of the disease type is associated with rather characteristic symptoms, clinical signs and laboratory findings, which are individually non-specific, but may provide helpful clues for a further focused diagnostic work-up. The clinician's task is to be able to identify these hallmark clinical features and to correctly interpret their significance and limitations in the appropriate differential diagnostic context. The aim of this review is to provide up-to-date clinical research evidence and to propose a concise clue-oriented diagnostic approach.

Keywords: diagnostic imaging, differential diagnosis, fever, granulomatous diseases, infections, inflammation, medical history taking, neoplasms, physical examination, rheumatic diseases.

Published: March 2, 2021  Show citation