ABSTRACT
BACKGROUND: Fever of unknown origin (FUO) is a diagnostic challenge with highly heterogeneous causes. Its etiology can change according to the studied regions, and the chance of reaching a diagnosis depends on available resources. The aim of this study is to describe the clinical characteristics, etiology and the usefulness of diagnostic aids in cases of FUO managed over 12 years in a Colombian reference center. METHODOLOGY: Single-institution retrospective case series. All cases of FUO between 2006 and 2017 were identified with the help of an electronic medical record search software. Cases of adults with fever for more than three weeks who remained undiagnosed after three days of hospitalization are described. RESULTS: Of 1,009 cases evaluated, 112 cases met the inclusion criteria (median age 43 years, 66% men). The etiologies identified were infectious (31.2%), inflammatory (20.5%), neoplastic (14.3%), and miscellaneous (2.7%) diseases. 31.2% remained without etiological diagnosis. The most frequent conditions were tuberculosis (17%), Hodgkin's lymphoma (7.1%), systemic lupus erythematosus (6.3%), disseminated histoplasmosis, and adult Still's disease. Contrast tomography and biopsies were the studies that most frequently supported or confirmed the final diagnosis. CONCLUSIONS: This series of contemporary Latin American cases suggests that the categories of FUO etiologies are similar to those reported in studies from developed countries, with tuberculosis being the most frequent cause in our setting. Our results highlight the importance of tomography-guided invasive studies in the diagnostic approach to FUO.
Subject(s)
Fever of Unknown Origin , Humans , Fever of Unknown Origin/etiology , Colombia/epidemiology , Male , Retrospective Studies , Adult , Female , Middle Aged , Young Adult , Aged , AdolescentABSTRACT
Introducción: La mortalidad asociada con sepsis e infecciones complicadas no se conoce en el departamento de Santander. Materiales y métodos: Se cuantificó la mortalidad por múltiples causas de muerte relacionadas con sepsis e infecciones complicadas. Los datos provienen de la base de datos de defunciones DANE año 2008. Se calcularon tasas específicas por edad, por sexo y tasas de mortalidad estandarizadas por edad utilizando el método directo. Resultados: En 2008, el 9% de las defunciones se asociaron con sepsis, 1 de cada 10 muertes. Los códigos CIE-10 relacionados como causas subyacentes de sepsis son diversos, aunque la neumonía, la enfermedad por virus del VIH y las infecciones urinarias son las más frecuentes en los diferentes grupos de edad. La mayor mortalidad ajustada se presenta en hombres y en los extremos de la vida. Conclusiones: Sepsis es un problema de salud pública en Santander. Este estudio se constituye en una línea de base para la evaluación de medidas para reducir la mortalidad por esta patología.
Introduction: The mortality associated with sepsis and complicated infections are not known in the department of Santander. Materials and methods: Mortality due to multiple causes related to sepsis and infections complicated was quantified. The data come from the DANE deaths database in 2008. Specific rates by age, sex and age-standardized mortality were calculated using the direct method. Results: In 2008, 9% of deaths were associated with sepsis, 1 in 10 deaths. ICD-10 codes related as underlying causes of sepsis are diverse but pneumonia, HIV virus disease and urinary tract infections are the most common in different age groups. The highest adjusted mortality was presented in men and in the extreme age groups. Conclusions: Sepsis is a public health problem in the department of Santander. This study provides a baseline for the evaluation of measures to reduce mortality from this disease.
