FEVER Without pyrogens Excessive heat Decreased Loss of production dissipation regulation TA>unchanged set-point
FEVER(without pyrogens) Excessive heat production T > unchanged set-point Decreased dissipation Loss of regulation
ACUTE FEBRILE ILLNESS a always represents a common problem a Acute onset with localizing sumptoms easy to get diagnosis a gradual onset without toxic r---only need follow-up are required a gradual onset with toxic -----hospitalization should be considered
ACUTE FEBRILE ILLNESS always represents a common problem Acute onset with localizing sumptoms -------easy to get diagnosis gradual onset without toxic -----only need follow-up are required gradual onset with toxic ------hospitalization should be considered
FEVER OF UNKNOWN ORIGIN Old definition 1. Fever higher than 383C on several occasions 2. Duration of fever -3 weeks 3. Uncertain diagnosis after one week of study in hospital New Definition D Eliminated the in-hospital evaluation requirements>3 outpatient visits, or 3 days in hospital.. Ambulatory as well as in hospital
FEVER OF UNKNOWN ORIGIN Old Definition: 1. Fever higher than 38.3oC on several occasions. 2. Duration of fever – 3 weeks 3. Uncertain diagnosis after one week of study in hospital New Definition: Eliminated the in-hospital evaluation requirements → 3 outpatient visits, or 3 days in hospital. … Ambulatory as well as in hospital
Epidemiology and etiology Categories of Illness Causing PUo Infections 30-40% Malignancies 20-25% Collagen Vascular disease 25-30% Undiagnosed 10-15%
Epidemiology and Etiology Infections 30 - 40 % Malignancies 20 – 25 % Collagen Vascular Disease 25 – 30 % Undiagnosed 10 – 15 % Categories of Illness Causing PUO
The Age ■ Children→ infection is the most frequent 口EB∨,CMV.. others ■Elde!y→ Neoplasm&CT- Disorders 口 Giant cell arteritis }>50yr(30%) a Polymyalgia Rheumatica y
The Age Children → infection is the most frequent. EBV, CMV… others Elderly → Neoplasm & CT-Disorders Giant cell arteritis } > 50 yr (30%) Polymyalgia Rheumatica }