Etiologies of FUo ■| nfection O Tuberculosis:. Disseminated Usually extrapulmonary Occurs in the lungs and significant pre-existing lung disease Pulmonary TB in AIDS is often subtle(normal chest X-rays→15-30%) a PPD(+)<50%of TB with PUO a Diagnosis often requires Bx of LN/Liver/Bone marrow Sputum smear(+)only 25% Clinic. various
Etiologies of FUO Infection Tuberculosis: .. Disseminated Usually extrapulmonary Occurs in the lungs and significant pre-existing lung disease. Pulmonary TB in AIDS is often subtle (normal chest x-rays → 15 – 30%). PPD (+) < 50% of TB with PUO. Diagnosis often requires Bx of LN/Liver/Bone marrow. Sputum smear (+) only 25% Clinic : various
E1.5T NL2006/(米06 Tuberculous brain abscesses Disseminated blood type lung tuberculosis tuberculous lymphadenitis Skin tuberculosis
Tuberculous brain abscesses Disseminated blood type lung tuberculosis tuberculous lymphadenitis Skin tuberculosis
Etiologies of FUo 口 Abscess Usually located in abdomen or pelvis Secondary to appendicitis or diverticulitis Pyogenic liver abscess usually follow biliary tract dis /abd. Suppuration Amoebic liver abscess is similar to pyogenic - amoebic serology is positive >95% of cases Splenic abscess is usually secondary to hematogenous seeding a Perinephric or renal abscess is usually secondary to UTI
Etiologies of FUO Abscess: Usually located in abdomen or pelvis. Secondary to appendicitis or diverticulitis. Pyogenic liver abscess usually follow biliary tract dis./abd. Suppuration. Amoebic liver abscess is similar to pyogenic → amoebic serology is positive > 95% of cases. Splenic abscess is usually secondary to hematogenous seeding. Perinephric or renal abscess is usually secondary to UTI
Etiologies of PUo a Bacterial Endocarditis a Culture remains negative in 5% of patient a Culture negative is likely with the following organisms. 口 Coxiella burnetii→ no growth 口 HACEK group→ incubate blood7-21days 口 Brucella 3 Special media/ 口 Legionella 3 long time 口 Mycoplasm/Chlamydia} 口 Funga→ usually sterile a Peripheral signs may not be detected Right-side Endocarditis→ Lack murmurs→self antibiotics ->growth(-ve)
Etiologies of PUO Bacterial Endocarditis Culture remains negative in 5% of patient. Culture negative is likely with the following organisms: Coxiella burnetii → no growth. HACEK group → incubate blood 7 – 21 days Brucella } Special media/ Legionella } long time Mycoplasm/Chlamydia } Fungal → usually sterile Peripheral signs may not be detected. Right-side Endocarditis → Lack murmurs → self antibiotics → growth (-ve)