Etiologies of Fuo ■| nfection a Tuberculosis:. Disseminated Usually extrapulmonary Occurs in the lungs and significant pre-existing lung disease a 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
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 a 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
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 Culture negative is likely with the following organisms 口 Coxiella burneti→ no growth 口 HACEK group→ incubate blood7-21days Brucella 1 Special media/ a Legionella y long time Mycoplasm/Chlamydia 口 Funga→ usually sterile a Peripheral signs may not be detected Right- side Endocarditis→ Lack murmurs→sef 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)