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Fever of Unknown Origin

2007 Edition, April 13, 2007

Complete Document

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Active, Most Current

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ISBN: 978-0-8493-3615-7
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Product Details:

  • Revision: 2007 Edition, April 13, 2007
  • Published Date: April 13, 2007
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 265
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


Fever of unknown origin is one of the most challenging diagnostic dilemmas in the field of infectious diseases. Since antiquity, fever has been a cardinal manifestation of infectious disease. In ancient medicine, the early descriptions of fever were concerned with acute, life-threatening infectious diseases. Through the ages, different fever patterns have been recognized, and their associations with various infectious disease disorders appreciated. The diagnostic significance of the relationship of pulse to temperature has been studied and remains an important way to assess the diagnostic significance of acute fevers. Yet, it was only during the 20th century that prolonged, unexplained, febrile disorders were given the emphasis they deserve in the medical literature. The fever patterns and characteristics of prolonged, febrile illnesses due to such infections as typhoid fever, chronic malaria, tuberculosis, and so on were studied in great detail. Gradually, the notion of acute versus prolonged fevers emerged in writings about the diagnostic approach to patients with fever.

In the modern era, prolonged, unexplained fevers were first put forth by Elliot Kieffer in his seminal work "Prolonged and Perplexing Fevers." While the characteristics of fevers and their associated infectious disorders had been well characterized by Osler in his classical textbook in 1894, Kieffer was the first to dedicate an entire work to prolonged fevers, which subsequently became known as fevers of unknown origin, or FUOs. Petersdorf published his classic study of fevers of unknown origin in 1961 and updated his findings 20 years later. Other important individuals who specialized in and wrote about diagnosing fevers of unknown origin included Weinstein, Wolff, and Louria. Medical as well as infectious disease textbooks now include entire chapters on fevers of unknown origin. Prior to the present volume, the most recent book was Fever of Undetermined Origin, edited by Henry W. Murray, and was published in 1983. Murray's accompanies Kieffer's as the only two textbooks devoted entirely to the subject of fever of unknown origin. The distribution of infectious and noninfectious disorders causing fever of unknown origin have changed as a result of an aging population, devices associated with medical procedures, and sophisticated diagnostic tests and radiologic procedures. While some newly recognized disorders presenting as fever of unknown origin have been described, in the main, there is a difference in distribution of disorders, both infectious and noninfectious that have been previously described in the fever of unknown origin literature and books.

So what is the rationale for a millennium book on fever of unknown origin? The answer is quite simple. There is a great need for a single sourcebook that utilizes the newer diagnostic tests that are important in diagnosing fevers of unknown origin. Not only has the distribution of disorders causing fevers of unknown origin changed, but new entities presenting as fever of unknown origin need to be addressed in a current treatise. This book on fevers of unknown origin is current and written by clinicians for clinicians. Accordingly, its perspective is distinctly clinical. The clinical diagnostic approach is emphasized throughout, as therapy has a minor role in the clinical approach to fevers of unknown origin. The tried and true principles of a pertinent history and physical examination are stressed, particularly a focused history and physical examination, which are especially important in the fever of unknown origin patient. Laboratory tests should not be ordered in a shotgun fashion, but selectively, and should reflect the likely diagnostic possibilities, as well as the clinical clues ascertained from the history, physical exam, or routine laboratory tests. Because fevers of unknown origin are such a common clinical problem, today's clinicians need an up-to-date and comprehensive book length reference to assist them in their clinical approach to patients. This book should become the standard reference text on fever of unknown origin for clinicians and remain useful for many years.