PYREXIA OF UNKNOWN ORIGIN. Dr. Alaa Jumaa. PUO is A Common disease presenting ATYPICALLY. Terminology . Old Definition : Petersdorf and Beeson (1961) Fever higher than 38.3 o C on several occasions. Duration of fever – 3 weeks
A Common disease presenting ATYPICALLY
Infection is the most frequent.
Modify the spectrum of PUO causing diseases:
J Postgrad Med 2001; 47(2):104-107
b. Factitious Fever
A history of exposure to wild or domestic animals should be solicited (zoonotic disease )
Ingestion of dirt is a particularly important clue to infection with Toxoplasma gondii (toxoplasmosis).
Ancestry from the Mediterranean should suggest the possibility of familial Mediterranean fever (FMF).
Lymphoma → may recur
Rheumatic Fever → may recur
Tertian & Quarter Pattern → Malaria
Pel-Ebstein Pattern → Lymphoma/Tuberculosis
Pulse-Temp Dissociation → Typhoid/Brucellosis
Cervical Area 1. Lymphoma
(Localized) 2. Tuberculosis
3. Infectious Mononucleosis
4. Lymphadenitis (bacterial)
↑ Hemi diaphragm } Abscess 2. Spleen
Pleural Effusion } 3. Pancreatic
initial NEGATIVE work-up are: