- The European Research Journal
- Volume:5 Issue:6
- Diagnostic utility of clinical and epidemiologic features in fever of unknown origin
Diagnostic utility of clinical and epidemiologic features in fever of unknown origin
Authors : Victor Roca CAMPAÑÁ, Rosa Eugenia Jiménez PANEQUE, Héctor Manuel Rodríguez SİLVA
Pages : 928-938
Doi:10.18621/eurj.441463
View : 35 | Download : 11
Publication Date : 2019-11-04
Article Type : Research Paper
Abstract :Objectives: To assess the diagnostic utility of clinical features in the major diagnostic categories of Fever of unknown origin insert ignore into journalissuearticles values(FUO);. Methods: One hundred and thirty-three patients meeting the classic criteria of FUO were included in the study. A structured diagnostic protocol was used in all cases. Sensitivity, specificity, positive and negative predictive values insert ignore into journalissuearticles values(PPV and NPVs);, and likelihood ratios of positive and negative tests insert ignore into journalissuearticles values(LR+ and LR-); were estimated with 95% confidence intervals insert ignore into journalissuearticles values(95% CIs); for all clinical findings. Results: Clinical and epidemiologic features with best diagnostic utility indexes for the three major diagnostic categories were: weight loss of 15 pounds or more insert ignore into journalissuearticles values(sensitivity, 68.4%, 95% CI: 52.33-84.52 );, pallor of the skin and mucous membranes insert ignore into journalissuearticles values(sensitivity, 65.7%, 95% CI: 49.39-82.19 );, prior medical history of cancer insert ignore into journalissuearticles values(PPV, 63.6%, 95% CI: 30.66-96.61; LR+, 4.38, 95% CI: 1.36-14.09);, lymphadenopathy insert ignore into journalissuearticles values(LR+, 2.2, 95% CI: 1.11-4.74 );, for neoplasms; arthritis insert ignore into journalissuearticles values(PPV, 72%, 95% CI: 51.84-93.61 );, prior family history of collagen diseases insert ignore into journalissuearticles values(PPV, 100%, 95% CI: 91.67-100.00);, neurologic disorder insert ignore into journalissuearticles values(LR+, 5.1, 95% CI: 1.37-19.68 );, myalgia insert ignore into journalissuearticles values(LR+, 4.1, 95% CI: 1.45-11.88 ); and skin lesions insert ignore into journalissuearticles values(LR+, 3.0, 95% CI: 1.51-6.22 ); for noninfectious inflammatory diseases; weight loss of 15 pounds or more insert ignore into journalissuearticles values(sensitivity, 50%, 95% CI: 27.91-72.09 );, epidemiological history of previous tuberculosis or tuberculosis exposure insert ignore into journalissuearticles values(LR+, 9.0, 95% CI: 1.76-46.77 );, and jaundice insert ignore into journalissuearticles values(LR+, 2.73, 95% CI: 0.7-10.63); for infections. Conclusions: We identified clinical data emerging from the anamnesis and physical examination that may help to guide the diagnostic process in FUO.Keywords : Fever of unknown origin, clinical features, diagnostic utility
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