A PROSPECTIVE STUDY ON THE MICROBIAL PROFILE OF PYREXIA OF UNKNOWN ORIGIN FROM INPATIENTS OF TERTIARY CARE HOSPITAL IN CHENNAI
Abstract
INTRODUCTION Fever could have many
causes including infective and non infective
origin. PUO is a clinical syndrome that
may result from much common aetiology
which was characterized by prolonged fever
without the signs or symptoms indicative
of a well defined disease process.
AIMS OBJECTIVES To find the infectious
causes of fever by microscopy, serology
and culture methods, To compare
quantitative buffy coat vs peripheral smear
study for the detection of malarial parasite
and To find out Antimicrobial Susceptibility
pattern of the organisms isolated.
MATERIALS METHODS Patients
with undiagnosed fever for more than
three weeks duration were included in this
study. Respective Specimens (blood,
urine, pus, CSF, sputum, throat swab)
were collected aseptically and processed
according to standard laboratory procedures.
RESULTS Among the 125 patients
selected 66 were males and 59 were females.
The causes of Pyrexia of unknown
origin were Infectious in 62.4,
Collagen disorder in 3.2, Neoplasm in 2.4,
Miscellaneous in6.4 and undiagnosed in
25.6 of patients. In Infectious causes
chronic urinary tract infection was the
commonest cause(12.8) followed by malarial
fever (11.2), Leptospirosis (10.4),
enteric fever (8.0) and others were documented
the source of PUO in the selected
group.CONCLUSION In 62.4 of cases
with fever more than 3 weeks were
caused by infectious origin. Causes were
unknown in 25.6 of patients.UTI was the
most common cause in infectious origin.
QBC is more sensitive to detect malarial
parasite than Peripheral smear study. The
sensitivity of Detection in Leptospiral aetiology
by MSAT were high compared with
IgM ELISA. Brucellosis, granulomatous
diseases and certain neoplastic disorders
would have contributed to the undiagnosed
group in the diagnosis of PUO.
Keyword :PUO, CSF, Malaria, Leptospirosis,
Tuberculosis
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PDFReferences
Shin’ichi Shoji et al-Fever of unknown
origin: A Review of 80 patients from the
Shin’etsu area ofJapan from 1986-
Internal Medicine vol-33,No-2
(February 1994) Pg 74-76
FJ Barbado et al-Pyrexia of unknown
origin: changing spectrum of diseases
in two consecutiveseries. Postgraduate
Medical Journal (1992) 68, Pg-
-887
PD Welsby- Pyrexia of unknown origin
sixty years on. Postgraduate Medical
Journal (1985)61, Pg-887-894
Robert G Petersdorf et al-FUO Revisited.
La Jolla and Seattle Pg 41-54
JV Hirschmann et al-Fever of unknown
origin in adults. Clinical infectious
diseases 1997, 24;Pg 291-302.
Jung A et al – Unexplained fever
analysis of 233 cases in a referral hospital.
Indian journal MedSci-1999,
Dec:53 (12): Pg 535-544
Effersoe- Pyrexia of unknown origin.
BMJ-19 July 1969: Pg 128-129
JVO Reid BM- Pyrexia of unknown
origin. BMJ-7 July 1956: Pg 23-25
Emanuel Appelbaum et al – The problem
of fever of unknown origin.
Bull.N.Y.Acad.Med vol-43: No-10:
October 1967
Gibson et al-Persistent fever in outpatients.
CAN.FAM.PHYSICIAN Vol-28,
December 1982.
Masashi Goto et al- A Retrospective
Review of 226 Hospitalized Patients with
fever. DOI:10.2169/internal medicine.
6038
Yayoi Iikuni et al-Current fever of unknown
origin 1982-1992. Internal Medicine
Vol 33, No.2(February 1994)
Moody A et al-Rapid diagnostic tests
for malaria parasites-Clin Microbiol review
: 15; Pg66-78
Handa R, Singh S, Singh N, Wali JP.
Fever of unknown origin: a prospective
study. Trop Doct1996;26:169-170.
D Kejariwal, SD Chakraborti et al-
Pyrexia of unknown origin –A Prospective
study of 100 cases-Journal of Post
graduate Medicine-2001-vol-47,Issue-
,Pg-104-107
Kashiwagi H. fever of unknown origin:
analysis of 56 cases between 1976 and
and areview of the litertures.Nippon
Naikagakkai Zasshi 75; 1214,1986.
Angela P. Brandão, Eide D.Camargo,
Emilson D. da Silva, Marcos V. Silva, and
Rui V. Abrão -Macroscopic Agglutination
Test for Rapid Diagnosis of HumanLeptospirosis.
J Clin Microbiol. 1998 November;
(11): 3138–3142.
Knockaert DC, Vanneste LJ, Vanneste
SB, Bobbaers HJ. Fever of unknown
origin in the 1980s:an update of
the diagnostic spectrum. Arch Intern-
Med:152;51,1992.
Deal WB. Fever of unknown origin:
analysis of 34 patients. Postgrad Med
: 182, 1971.
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