DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20164413

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

Abstract


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.


Keywords


Children, Enteric fever, Fever, FUO, Infections

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References


Long SS, Edwards KE. Prolonged, recurrent and periodic fever syndromes. In: Principals and Practice of Pediatric Infectious disease, 4th ed, Elsevier, Churchill Livingstone; 2012:117-118.

Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine Baltimore. 1961;40:1-30.

Joshi N, Rajeshwari K, Dubey AP, Singh T, Kaur R. Clinical spectrum of fever of unknown origin among Indian children. Ann Trop Paediatr. 2008;28(4):261-6.

Oberoi SS. Updating income ranges for Kuppusamy’s socio-economic status scale for the year 2014. Indian J Public Health. 2015;59:156-7.

Kejariwal D, Sarkar N, Chakraborti SK, Agarwal V, Roy S. Pyrexia of unknown origin: a prospective study of 100 cases. J Postgrad Med. 2001;47:104.

Mir T, Dhobi GN, Koul AN, Saleh T. Clinical profile of classical FUO. Caspian J Intern Med. 2014;5(1):35-9.

McClung HJ. Prolonged fever of unknown origin in children. Am J Dis Child. 1972;124(4):544-50.

Pizzo PA, Lovejoy FH, Smith DH. Prolonged fever in children: review of 100 cases. Pediatr. 1975;55(4):468-73.

Chantada G, Casak S, Plata JD, Pociecha J, Bologna R. Children with fever of unknown origin in Argentina: an analysis of 113 cases. Pediatr Infect Dis J. 1994;13(4):260-3.

Cogulu O, Koturoglu G, Kurugol Z, Ozkinay F, Vardar F, Ozkinay C. Evaluation of 80 children with prolonged fever. Pediatr Int. 2003;45(5):564-9.

Bakashvili LZ, Makhviladze MA, Pagava EK, Pagava KI. Fever of unknown origin in children and adolescents in Georgia: a review of 52 patients. Georgian Med News. 2006;(135):66-9.

Hassan RH, Fouda AE, Kandil SM. Fever of unknown origin in children: a 6 year- experience in a tertiary pediatric Egyptian hospital. Int J Health Sci Qassim. 2014;8(1):13-9.

Cruz ML, Andarali J, Perira MN. Leptospirosis in children. Rev SOC Bras Med Tropical. 1994;27(1):5-9.

Sharma A, Mahajan S, Gupta ML, Kanga A, Sharma V. Investigation of an outbreak of scrub typhus in the himalayan region of India. Jpn J Infect Dis. 2005;58(4):208-10.

Premaratna R, Loftis AD, Chandrasena TG, Dasch GA, de Silva HJ. Rickettsial infections and their clinical presentations in the Int J Infect Dis. 2008;12(2):198-202.

Chow A, Robinson JL. Fever of unknown origin in children: a systematic review. World J Pediatr. 2011;7(1):5-10.