Fever of unknown origin laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: febris continua e causa ignota; febris e causa ignota; febris E.C.I.; fever/pyrexia of obscured/undetermined/uncertain/unidentifiable/unknown focus/origin/source; fever/pyrexia without a focus/origin/source; FUO; PUO

Laboratory Workup of Fever of Unknown Origin

Laboratory work up for FUO is directed by history and physical examination which may provide some clues helping in narrowing down investigations. However some laboratory investigations listed below are mandatory in cases of FUO.^[1]^[2]^[3]

Complete blood count with differential
Hemoglobin
Basic metabolic panel
Liver function test including aminotransferases (AST and ALT), LDH, bilirubin, and alkaline phosphatase
Creatine kinase
Blood cultures (at least 2 sets)
Urinalysis with microscopic examination
Urine cultures
Erythrocyte sedimentation rate
C-reactive protein
Gamma-glutamyl transferase
Antinuclear antibodies
Rheumatoid factor
Serum protein electrophoresis
Tuberculin skin test

Other Laboratory work up done in case FUO other than mandatory work up are :^[4]^[5]

HIV serology
Coombs test
Cold agglutinins
Heterophile antibody test
Thyroid peroxidase and anti thyroid antibody test

References

↑ Mulders-Manders C, Simon A, Bleeker-Rovers C (2015). “Fever of unknown origin”. Clin Med (Lond). 15 (3): 280–4. doi:10.7861/clinmedicine.15-3-280. PMC 4953114. PMID 26031980.
↑ Kaya A, Ergul N, Kaya SY, Kilic F, Yilmaz MH, Besirli K; et al. (2013). “The management and the diagnosis of fever of unknown origin”. Expert Rev Anti Infect Ther. 11 (8): 805–15. doi:10.1586/14787210.2013.814436. PMID 23977936.
↑ Hayakawa K, Ramasamy B, Chandrasekar PH (2012). “Fever of unknown origin: an evidence-based review”. Am J Med Sci. 344 (4): 307–16. doi:10.1097/MAJ.0b013e31824ae504. PMID 22475734.
↑ Hirschmann, J. V. (1997-03). “Fever of unknown origin in adults”. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 24 (3): 291–300, quiz 301-302. ISSN 1058-4838. PMID 9114175. Check date values in: |date= (help)
↑ Cunha, Burke A. (2007-12). “Fever of unknown origin: focused diagnostic approach based on clinical clues from the history, physical examination, and laboratory tests”. Infectious Disease Clinics of North America. 21 (4): 1137–1187, xi. doi:10.1016/j.idc.2007.09.004. ISSN 0891-5520. PMID 18061092. Check date values in: |date= (help)

[pmid26031980-1] Mulders-Manders C, Simon A, Bleeker-Rovers C (2015). “Fever of unknown origin”. Clin Med (Lond). 15 (3): 280–4. doi:10.7861/clinmedicine.15-3-280. PMC 4953114. PMID 26031980.

[pmid23977936-2] Kaya A, Ergul N, Kaya SY, Kilic F, Yilmaz MH, Besirli K; et al. (2013). “The management and the diagnosis of fever of unknown origin”. Expert Rev Anti Infect Ther. 11 (8): 805–15. doi:10.1586/14787210.2013.814436. PMID 23977936.

[pmid22475734-3] Hayakawa K, Ramasamy B, Chandrasekar PH (2012). “Fever of unknown origin: an evidence-based review”. Am J Med Sci. 344 (4): 307–16. doi:10.1097/MAJ.0b013e31824ae504. PMID 22475734.

[4] Hirschmann, J. V. (1997-03). “Fever of unknown origin in adults”. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 24 (3): 291–300, quiz 301-302. ISSN 1058-4838. PMID 9114175. Check date values in: |date= (help)

[5] Cunha, Burke A. (2007-12). “Fever of unknown origin: focused diagnostic approach based on clinical clues from the history, physical examination, and laboratory tests”. Infectious Disease Clinics of North America. 21 (4): 1137–1187, xi. doi:10.1016/j.idc.2007.09.004. ISSN 0891-5520. PMID 18061092. Check date values in: |date= (help)

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