Year 2019, Volume 5 , Issue 6, Pages 928 - 938 2019-11-04

Diagnostic utility of clinical and epidemiologic features in fever of unknown origin

Victor Roca Campañá [1] , Rosa Eugenia Jiménez Paneque [2] , Héctor Manuel Rodríguez Silva [3]


Objectives: To assess the diagnostic utility of clinical features in the major diagnostic categories of Fever of unknown origin (FUO).

Methods: One hundred and thirty-three patients meeting the classic criteria of FUO were included in the study. A structured diagnostic protocol was used in all cases. Sensitivity, specificity, positive and negative predictive values (PPV and NPVs), and likelihood ratios of positive and negative tests (LR+ and LR-) were estimated with 95% confidence intervals (95% CIs) for all clinical findings.

Results: Clinical and epidemiologic features with best diagnostic utility indexes for the three major diagnostic categories were: weight loss of 15 pounds or more (sensitivity, 68.4%, 95% CI: 52.33-84.52), pallor of the skin and mucous membranes (sensitivity, 65.7%, 95% CI: 49.39-82.19), prior medical history of cancer (PPV, 63.6%, 95% CI: 30.66-96.61; LR+, 4.38, 95% CI: 1.36-14.09), lymphadenopathy (LR+, 2.2, 95% CI: 1.11-4.74), for neoplasms; arthritis (PPV, 72%, 95% CI: 51.84-93.61), prior family history of collagen diseases (PPV, 100%, 95% CI: 91.67-100.00), neurologic disorder (LR+, 5.1, 95% CI: 1.37-19.68), myalgia (LR+, 4.1, 95% CI: 1.45-11.88) and skin lesions (LR+, 3.0, 95% CI: 1.51-6.22) for noninfectious inflammatory diseases;  weight loss of 15 pounds or more (sensitivity, 50%, 95% CI: 27.91-72.09), epidemiological history of previous tuberculosis or tuberculosis exposure (LR+, 9.0, 95% CI: 1.76-46.77), and jaundice (LR+, 2.73, 95% CI: 0.7-10.63) for infections.

Conclusions: We identified clinical data emerging from the anamnesis and physical examination that may help to guide the diagnostic process in FUO.

Fever of unknown origin, clinical features, diagnostic utility
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Primary Language en
Subjects Infectious Diseases, General and Internal Medicine
Journal Section Original Articles
Authors

Orcid: 0000-0002-8346-6521
Author: Victor Roca Campañá (Primary Author)
Institution: Department of Internal Medicine, Clinical Surgical Hospital "Hermanos Ameijeiras". Havana, Cuba
Country: Cuba


Orcid: 0000-0001-9647-3061
Author: Rosa Eugenia Jiménez Paneque
Institution: Department of Nursing, Autonomous University of Chile, Faculty of Health Sciences, Santiago, Chile
Country: Chile


Orcid: 0000-0002-3648-2609
Author: Héctor Manuel Rodríguez Silva
Institution: Department of Internal Medicine, Clinical Surgical Hospital "Hermanos Ameijeiras". Havana, Cuba
Country: Cuba


Dates

Publication Date : November 4, 2019

EndNote %0 The European Research Journal Diagnostic utility of clinical and epidemiologic features in fever of unknown origin %A Victor Roca Campañá , Rosa Eugenia Jiménez Paneque , Héctor Manuel Rodríguez Silva %T Diagnostic utility of clinical and epidemiologic features in fever of unknown origin %D 2019 %J The European Research Journal %P -2149-3189 %V 5 %N 6 %R doi: 10.18621/eurj.441463 %U 10.18621/eurj.441463