role of parasitic infections in fever of undetermined origin among Egyptians in Dakahlia, epidemiological, clinical and diagnostic evaluation

ABSTRACT

This study investigated the role of parasitic infections as possible etiologic agents in prolonged fever of undetermined origin [FUO]. The value of some diagnostic serological tests was also proved. 43 patients who fulfilled the international criteria for prolonged fever were studied. All cases were exposed to urine examination and culture, stools examinations, hemogram, liver and renal function tests, chest X-ray, tuberculin test, bone marrow, liver biopsy, blood films, serological tests including ELISA, IHA and IFA for detection of schistosomiasis, leishmaniasis, toxoplasmosis and malaria. The majority of cases with positive parasitic etiology were coming from rural areas. The pattern of fever was predominantly intermittent especially with malarial and schistosomal cases. Lymphadenopathy was detected in one third of cases, 60% of which were visceral leishmaniasis. The IHA test for leishmaniasis detected all cases at a titer of 256, 512 and 1024 reciprocally. The dot-ELISA detected 8 out of the 10 cases diagnosed by the IHA test. The detection of seropositive cases of visceral leishmaniasis in the studied area suggests the existence of reservoir or a focus and warrants epidemiological study to establish the actual situation