Clinicoetiological profile of pyrexia of unknown origin in children 1-12 years of age in a tertiary care centre
DOI:
https://doi.org/10.18203/2349-3291.ijcp20231483Abstract
Background: A primary concern of the paediatricians in evaluating a child with PUO is the limited use of investigations that are case-specific especially in developing countries such as India where availability and affordability are the limiting factors. Hence, this study was conducted to evaluate the various etiological factors and the clinical profile of children presenting with PUO in this region.
Methods: A hospital based cross sectional study was conducted among 200 children presenting with fever i.e., temperature >100.9⁰F/38.3 ⁰C of more than one week duration, with no clear diagnosis after initial investigations
Results: A total of 193 children were included in the study with a mean age of 6.2±1.8 years. Most (62.5%) of the participants had infectious etiology, followed by collagen vascular disorders (10 %) and malignancies (9.5%). Among the participants, 10% remain undiagnosed. Among infectious causes, the most common was respiratory tract infections (17.5%), followed by scrub typhus (13.5%) and urinary tract infections (10%).
Conclusions: Our study was conducted to outline the clinic-etiological profile of pediatric patients with PUO in our region. After proper investigations, a diagnosis could be reached in most patients. The commonest aetiology was infectious, followed by collagen vascular disorders and malignancies. Further studies with a larger sample size are suggested.
Metrics
References
Nalli RK, Velampalli S, Borigama N. A Prospective Study of Clinico-Aetiological Profile of Fever of Unknown Origin in Children Admitted to a Tertiary Care Center. J Evid Based Med Health. 2020;40:2255-61.
Wing R, Dor MR, Mcquilkin PA. Fever in the pediatric patient. Emerg Med Clin North Am. 2013;31:1073-96.
Antoon JW, Potisek NM, Lohr JA. Pediatric Fever of Unknown Origin. Pediatr Rev. 2015;36:380-90.
Attard L, Tadolini M, De Rose DU, Cattalini M. Overview of fever of unknown origin in adult and paediatric patients. Clin Exp Rheumatol. 2018;36(110):S10-24.
Dall L, Stanford JF. Fever, Chills, and Night Sweats. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths. 1990;211.
Wassim Abdelwahab E. Pyrexia of Unknown Origin: Current Perspectives. Int J Biomed Res. 2019;10(1):e4987.
Petersdorf RG, Beeson PB: Fever of unexplained origin: report on 100 cases. Medicine (Baltimore). 1961;40:1-30.
Durack DT, Street AC. Fever of unknown origin--reexamined and redefined. Curr Clin Top Infect Dis. 1991;11: 35-51.
Arnow PM, Flaherty JP. Fever of unknown origin. Lancet. 1997;350:575-80.
Chow A, Robinson JL. Fever of unknown origin in children: a systematic review. World J Pediatr. 2011;7(1):5-10.
Sumathisri R, Pandi K, Srinivasan S. Fever in the tropics: aetiology and clinical profile of fever of unknown origin in children-a prospective observational study in a tertiary care hospital in South India. Int J Contemp Pediatr. 2019;6:1834-8.
Tezer H, Ceyhan M, Kara A, Cengiz AB, Devrim İ, Seçmeer G. Fever of unknown origin in children: the experience of one center in Turkey. Turk J Pediatr. 2012;54(6):583-9.
Kejariwal D, Sarkar N, Chakraborti SK, Agarwal V, Roy S. Pyrexia of unknown origin: a prospective study of 100 cases. J Postgrad Med. 2001;47(2):104-7.
Govindarajulu S, Kalyanasundaram K, Pyarejan KS, Venkatasamy S. Clinical profile and aetiological spectrum of fever of unknown origin in children aged 2 months to 12 years. Int J Contemp Pediatr. 2017;4(1):62-7.
Chantada G, Casak S, Plata JD, Pociecha J, Bologna R. Children with fever of unknown origin in Argentina: an analysis of 113 cases. Pediatric Infect Dis J. 1994;13(4):260-3.
Joshi N, Rajeshwari K, Dubey AP, Singh T, Kaur R. Clinical spectrum of fever of unknown origin among Indian children. Ann Trop Pediatr. 2008;28(4):261-6
Ergin C, Erdal U. Pyrexia of unknown origin in children: a review of 102 patients from Turkey. Ann Trop Paediatr. 2003;23(4):259-63.
Pasic A, Minic P, Djuric D. Fever of unknown origin in 185 paediatric patients: a single-centre experience. Acta Paediatr. 2007;95:463-66.
Kim YS, Kim KR, Kang JM, Kim JM, Kim YJ. Aetiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center. Korean J Pediatr. 2017;60(3):77-85.