Ravi Kumar Nalli1 , Shashikala Velampalli2 , Naveenkumar Borigama3
BACKGROUND Fever among children not only shoots up the temperature of child but also the anxiety of parents and pressure on the treating paediatrician to diagnose the condition as soon as possible. Fever of unknown origin is one of the leading causes of morbidity and mortality among children worldwide and the spectrum keeps changing constantly from time to time. We wanted to study the aetiology of fever of unknown origin in different age groups, and clinical profiles. We also wanted to evaluate the importance of advanced investigations in the evaluation of fever of unknown origin. METHODS This is a prospective observational study conducted in the Department of Paediatrics for a period of 2 years. A total of 100 children were enrolled in the study who were admitted with fever > 101 F [38.3 °C] of at least 8 days duration, in whom no diagnosis was reached after initial outpatient or hospital evaluation. RESULTS A total of 100 cases was enrolled in the study: The male to female ratio was 1.3 : 1. Children in the age group of 3 - 6 years constituted the majority of the study population. Infections (38 %) were the commonest cause of the FUO, followed by malignancy (24 %) and NIID (22 %). Undiagnosed group was followed by ALL, JRA, TB, UTI, enteric fever and SLE in that order. Between 1 - 3 years, malignancy (especially acute lymphoblastic leukemia) was the commonest cause. Between 3 - 6 years, infections are the commonest cause of fever of unknown origin. After 9 years, non-infective inflammatory diseases were the most common cause of FUO. In infants UTI was the commonest infection in FUO. Between 1 - 12 years, tuberculosis was the commonest Infection. ALL was the commonest malignancy presenting as FUO in older children between 9 - 12 years of age. CONCLUSIONS Over a period of time, with the advent of newer diagnostic techniques and improved imaging facilities, more cases of undiagnosed FUO cases are diagnosed which will help in better management of patients with good outcome.
