Fever of unknown origin medical therapy

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

Overview

Since FUO can have variety of etiologies therefore it does not have a standard treatment regimen. However the treatment is usually directed towards the target from potential clues in the History and Physical examination.^[1]^[2]

Medical Therapy

Empiric antibiotics

Use of empiric antibiotics should not be encouraged unless the patient is neutropenic or immunocompromised, so that proper workup can be done and a more targeted treatment be given.

Steroids

Steroids should not be given early as it can mask effects of many diseases.
however they can be given early in cases of Giant cell temporal arteritis to prevent blindness.
they are used in rheumatologic causes of FUO.

NSAIDS

Non-steroidal anti-inflammatory drugs are given when no cause is found despite extensive work up.

Anakinra

Interleukin 1 antagonist are give in cases of autoimmune disorders. If no symptomatic improvement occurs after 2 weeks drug should be stopped.

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.
↑ Wright WF, Auwaerter PG (2020). “Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma”. Open Forum Infect Dis. 7 (5): ofaa132. doi:10.1093/ofid/ofaa132. PMC 7237822 Check |pmc= value (help). PMID 32462043 Check |pmid= value (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.

[pmid32462043-2] Wright WF, Auwaerter PG (2020). “Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma”. Open Forum Infect Dis. 7 (5): ofaa132. doi:10.1093/ofid/ofaa132. PMC 7237822 Check |pmc= value (help). PMID 32462043 Check |pmid= value (help).

[1]

[2]