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