RT Book, Section
A1 Shah, Samir S.
A1 Alpern, Elizabeth R.
A2 Zaoutis, Lisa B.
A2 Chiang, Vincent W.
SR Print(0)
ID 1146118155
T1 Prolonged Fever and Fever of Unknown Origin
T2 Comprehensive Pediatric Hospital Medicine, 2e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071829281
LK accesspediatrics.mhmedical.com/content.aspx?aid=1146118155
RD 2024/09/15
AB In  1961,  Petersdorf  and  Beeson  proposed  their  now  classic  criteria  for  fever  of  unknown  origin  (FUO):  (1)  an  illness  of  at  least  3  weeks’  duration,  (2)  measured  temperatures  greater  than  38.3°C  on  several  occasions,  and  (3)  no  etiologic  diagnosis  after  1  week  of  hospitalization.1  For  adult  patients,  Durack  and  Street2  modified  the  third  criterion  of  this  definition  to  account  for  potential  outpatient  evaluation  by  substituting  “3  outpatient  visits  or  at  least  3  days  in  the  hospital”  for  “1  week  of  hospitalization.”  Studies  focusing  on  pediatric  patients  have  occasionally  used  fever  duration  of  2  rather  than  3  weeks.  Patients  presenting  with  2  to  3  weeks  of  fever  but  not  meeting  all  the  criteria  for  FUO  are  often  referred  to  as  having  prolonged  fever.  Differentiating  prolonged  fever  from  FUO  can  be  impractical,  because  the  diagnostic  criteria  for  FUO  do  not  specify  the  type  or  extent  of  evaluation  required.  Final  diagnoses  are  determined  in  a  number  of  ways  (e.g.  natural  history,  biopsy,  imaging,  serologic  studies)  and  no  single  patient  either  receives  or  requires  every  diagnostic  test.  This  chapter  discusses  the  evaluation  of  a  child  with  prolonged  fever  in  whom  the  cause  of  fever  is  not  readily  apparent.