Clinico-epidemiological profile of fever of unknown origin in an Egyptian setting: A hospital-based study (2009–2010)

  • Ahmed F Kabapy High Institute of Public Health, Alexandria University, Egypt
  • Amira M Kotkat High Institute of Public Health, Alexandria University, Egypt
  • Hanan Zakaria Shatat High Institute of Public Health, Alexandria University, Egypt
  • Ekram W Abd El Wahab High Institute of Public Health, Alexandria University, Egypt
Keywords: fever of unknown origin, classical, infectious diseases, collagen vascular diseases

Abstract

Introduction: Fever of unknown origin (FUO) is one of the most challenging diagnostic dilemmas in the field of infectious diseases and tropical medicine. Clinicians should use the frequency distribution of disorders causing FUO to guide their diagnostic approach in patients with prolonged, unexplained fevers meeting the definition of FUO.

Methodology: The present study was undertaken to examine the etiologies, clinico-epidemiologic profile, and prognosis of classical FUO in patients reporting to the Alexandria Fever Hospital in Egypt. Records of 979 patients admitted to the fever hospital (from January 2009 to January 2010) and diagnosed as having FUO were examined carefully. FUO was defined as three outpatient visits or three days in the hospital without elucidation of cause of fever.

Results: A total of 979 cases (57.0% males and 43.0% females), with ages ranging from 0.2 to 90 years, were investigated. The mean duration of fever before hospitalization was 31 ± 10 days. The etiology of FUO was delineated in 97% of cases, and only 3% remained undiagnosed. Diagnoses were grouped into five major categories. Infectious causes of FUO were strongly associated with better outcome (73.7% improved). Smoking, contact with animals or birds, drug addiction, and HIV seropositivity were important risk factors associated with infections.

Conclusions: Infections are the most common cause of FUO, followed by collagen vascular diseases, in our region. A three-step diagnostic work-up approach is recommended to be applied in Egypt in order to improve the quality of medical service provided to FUO patients.

Author Biographies

Ahmed F Kabapy, High Institute of Public Health, Alexandria University, Egypt

tropical Health Department

Alexandria Fever Hospital

Ekram W Abd El Wahab, High Institute of Public Health, Alexandria University, Egypt
Lecturer in Tropical Health Depaetment
Published
2016-01-31
How to Cite
1.
Kabapy AF, Kotkat AM, Shatat HZ, Abd El Wahab EW (2016) Clinico-epidemiological profile of fever of unknown origin in an Egyptian setting: A hospital-based study (2009–2010). J Infect Dev Ctries 10:30-42. doi: 10.3855/jidc.7198
Section
Original Articles