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- $Unique_ID{BRK00634}
- $Pretitle{}
- $Title{Fever Source}
- $Subject{fever diagnoses Ill Defined Symptoms symptom blood temperature
- temperatures FUO fevers unknown origin neoplasms neoplasm cancer cancers
- carcinoma lymphoma leukemia solid tumors infections fungal bacteria rheumatic
- lupus erythematosus hepatitis gout infection}
- $Volume{N-7}
- $Log{}
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- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
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- Fever Source
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- QUESTION: I had a fever recently, which my doctor diagnosed as being caused
- by a localized infection. In the course of treating me, he mentioned that it
- is impossible to successfully uncover the source of a fever. Is he correct?
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- ANSWER: Unfortunately, your doctor is right. While most fevers are either
- temporary or traceable to a specific ailment, there is a group referred to as
- FUO--fevers of unknown origin. To be included in this classification, the
- fever must be present and have eluded normal attempts at diagnosis for at
- least three weeks. The fever may fall into one of four patterns: a)
- intermittent; where the temperature returns to a normal level on a daily
- basis, b) remittent; the fever remains although the temperature subsides to a
- lower level daily, c) a sustained, consistent fever, and d) a relapsing fever
- that vanishes for days at a time, only to return.
- Most of these fevers can eventually be diagnosed, but only with a
- sustained investment of time and effort on the part of the doctor and
- increased costs for the patient. The physician first constructs a complete
- patient history, emphasizing recent travel, new pets or plants, work
- environment, visits to sick friends or relatives, as well as other factors
- that can help narrow the range of possible causes. A daily physical exam
- paying close attention to subtle details (the base of nails, skin condition,
- mucous membranes, the condition of lymph nodes or hidden rashes) is also a
- must, together with repeated lab tests on blood, urine or stool samples.
- Occasionally, x-ray studies, CT scanning, endoscopies or even biopsies may be
- necessary.
- In most cases, these procedures will eventually yield definitive answers.
- Unfortunately, the majority of these fevers are caused by neoplasms--abnormal
- tissue growth--including lymphoma, leukemia and solid tumors. Infections
- account for one-third of FUO cases: system-wide infections are most often
- traced back to fungal bacteria, while localized infections are generally
- centered in the abdomen. A variety of other diseases account for almost all
- the remaining fevers, including rheumatic fever, lupus erythematosus,
- hepatitis and gout. However, some 10% of these mysterious fevers still defy
- diagnosis, in spite of today's advanced medical knowledge and technology.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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