Fever of Unknown Origin in Children: A 14-Year, Single Institution Retrospective Review.

AIM: To glean additional knowledge on children with fever of unknown origin (FUO).

METHODS

Children <18 years old referred to Infectious Disease Service for FUO in a tertiary paediatric hospital were analysed retrospectively from December 2004 to January 2019. Clinical profile, interventions and outcomes were reviewed.

RESULTS

There were 272 children evaluated (median age 81.5 months, 56.3% males). Causes identified were infections (54.0%), inflammatory (17.3%), haematology/oncological (6.6%), others/unknown (22.1%). The most common infection was typhoid fever. Kikuchi-Fujimoto Disease was the most common inflammatory cause, while haemophagocytic lymphohistiocytosis was the most common haematology/oncological cause. Children ≥ 5 years were more likely to have an inflammatory cause. Cough was associated with infections; mouth ulcers, joint pain and lymphadenopathy with inflammatory disorders. Hepatomegaly, splenomegaly, anaemia and raised C-reactive protein were associated with haematology/oncological conditions.

CONCLUSIONS

We provide insights into knowledge of paediatric FUO and identify clinical associations with infection, inflammatory and haematological/oncological conditions.