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Diagnostic approach to the fever of unknown origin in children - Emphasis on the infectious diseases -

Korean Journal of Pediatrics 2007;50(2):127-131.
Published online February 15, 2007.
Diagnostic approach to the fever of unknown origin in children - Emphasis on the infectious diseases -
Eun Hwa Choi
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
소아에서 원인불명열의 진단적 접근 - 감염성 질환을 위주로 하여-
서울대학교 의과대학 소아과학교실
Eun Hwa Choi, Email: eunchoi@snu.ac.kr
Fever of unknown origin (FUO) has been a convenient term used to classify patients who warrant a particular systemic approach to diagnostic evaluation and management. The greatest clinical concern in evaluating FUO is identifying patients whose fever has a serious or life-threatening cause when a delay in diagnosis could jeopardize successful intervention. Thorough history and complete physical examination are critical to uncover the etiologic diagnosis. Most cases of FUO in children are caused by atypical presentations of common diseases rather than by typical manifestations of rare disorders. Selection of diagnostic tests and speed of investigation should be guided by a knowledge of the disease severity, patient age, epidemiologic and geographic information, and any positive findings from a detailed history and physical examination. The three most common causes of FUO in children are infectious diseases, connective tissue diseases, and malignancy. In general, the prognosis of FUO in children is better than that of adults. Although the outcome is dependent on the primary disease process, fever abates spontaneously in most cases in whom the cause of fever remains unclear.
Key Words: Fever of unknown origin, Prolonged fever, Children

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