Clinical profile and etiological spectrum of fever of unknown origin in children aged 2 months to 12 years

Santhosh Govindarajulu, Kumarasamy Kalyanasundaram, Karamath S. Pyarejan, Seenivasan Venkatasamy


Background: Fever of unknown origin is one of the leading etiologies for morbidity and mortality among children worldwide and their spectrum keeps changing constantly from time to time. The objective of this study was to study the clinical profile and etiological spectrum of fever beyond 2 weeks duration in children aged 2 months to 12 years admitted in a tertiary care hospital.

Methods: A prospective observational study, done in tertiary care centre over six month period (May 2016 to October 2016). Children aged 2 months to 12 years presenting with fever beyond 2 weeks duration fulfilling the inclusion criteria were included in the study and evaluated further. Initial investigations include complete blood count including peripheral smear for MP/malignancy, urine routine, chest X-ray, mantoux, CRP, blood and urine cultures were done followed by specific serology tests and further relevant investigations. The etiological outcomes were mainly analysed.

Results: The etiological outcomes of the study were classified into 5 groups as infections, malignancies, connective tissue disorder, miscellaneous and undiagnosed. Among the study population, infection emerged as the major etiological outcome constituting 69.1% followed by malignancies (16.7%), connective tissue disorder (5%), miscellaneous (5.8%) and undiagnosed (3.4%).

Conclusions: Infections, especially enteric fever still remains the leading etiology of fever beyond 2 weeks duration or FUO in children aged 2months to 12 years. Irrational usage of antibiotics has been highlighted in general practice which needs to be amended by periodic discussions and epidemiological surveys to prevent the emergence of drug resistance.


Children, Enteric fever, Fever, FUO, Infections

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