eMedicine Specialties > Infectious Diseases > Special Topics

Fever of Unknown Origin: Treatment & Medication

Author: Kirk M Chan-Tack, MD, Fellow, Division of Infectious Disease, University of Maryland School of Medicine
Coauthor(s): John Bartlett, MD, Chief of Division of Infectious Diseases, Chief of HIV Care Service, Professor, Department of Internal Medicine, Johns Hopkins University School of Medicine
Contributor Information and Disclosures

Updated: Sep 23, 2008

Treatment

Medical Care

  • In general, empiric therapy has little or no role in cases of classic fever of unknown origin (FUO).
  • Treatment should be directed toward the underlying cause, as needed, once a diagnosis is made.
  • Some studies suggest a few exceptions to this general approach, including the following:
    • Cases that meet criteria for culture-negative endocarditis
    • Cases in which findings or the clinical setting suggests cryptic disseminated TB (or, occasionally, other granulomatous infections)
    • Cases in which temporal arteritis with vision loss is suspected.
  • Several studies have found that prolonged undiagnosed FUO generally carries a favorable prognosis.

Surgical Care

Because of a better understanding of the etiologies and careful diagnostic approaches, patients with FUO rarely need surgical treatment.

Consultations

Appropriate consultations are indicated based on patient history, physical examination, laboratory data, and radiologic findings, including the following:

  • Infectious disease specialist
  • Hematologist/oncologist
  • Rheumatologist
  • Pulmonologist
  • Gastroenterologist
  • Endocrinologist
  • Interventional radiologist
  • Surgeon

Medication

The medications used depend on the etiology of the fever of unknown origin (FUO).

More on Fever of Unknown Origin

Overview: Fever of Unknown Origin
Differential Diagnoses & Workup: Fever of Unknown Origin
Treatment & Medication: Fever of Unknown Origin
Follow-up: Fever of Unknown Origin
References
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References

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Further Reading

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Keywords

fever of unknown origin, FUO, febris, pyrexia, febrile illness, idiopathic fever, fever of undetermined origin, high temperature, feverish, bacteremia, bacterial disease, tuberculosis, urinary tract infection, UTI, endocarditis, hepatobiliary infection, osteomyelitis, Borrelia recurrentis, B recurrentis, Spirillum minor, S minor, Borrelia burgdorferi, B burgdorferi, Treponema pallidum, T pallidum, Rickettsia, Coxiella burnetii, C burnetii, chronic Q fever, Q fever endocarditis, rickettsial disease, Lyme disease, syphilis, rat-bite fever, ratbite fever, rat bite fever, herpes, herpes virus, acquired immunodeficiency syndrome, AIDS, human immunodeficiency virus, HIV, collagen vascular disease, autoimmune disease, granulomatous disease, drug fever, relapsing fever, hyperthyroidism, subacute thyroiditis, factitious fever

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Contributor Information and Disclosures

Author

Kirk M Chan-Tack, MD, Fellow, Division of Infectious Disease, University of Maryland School of Medicine
Kirk M Chan-Tack, MD is a member of the following medical societies: American College of Physicians, American Medical Association, Christian Medical & Dental Society, Physicians for Social Responsibility, and Southern Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

John Bartlett, MD, Chief of Division of Infectious Diseases, Chief of HIV Care Service, Professor, Department of Internal Medicine, Johns Hopkins University School of Medicine
John Bartlett, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Clinical Pharmacology, American College of Physicians, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, American Thoracic Society, American Venereal Disease Association, Association of American Physicians, Infectious Diseases Society of America, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Medical Editor

Wesley W Emmons, MD, FACP, Assistant Professor, Department of Medicine, Thomas Jefferson University; Consulting Staff, Infectious Diseases Section, Department of Internal Medicine, Christiana Care, Newark, DE
Wesley W Emmons, MD, FACP is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and International AIDS Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Charles V Sanders, MD, Edgar Hull Professor and Chairman, Department of Internal Medicine, Professor of Microbiology, Immunology and Parasitology, Louisiana State University School of Medicine at New Orleans; Medical Director, Medicine Hospital Center, Charity Hospital and Medical Center of Louisiana at New Orleans; Consulting Staff, Ochsner Medical Center
Charles V Sanders, MD is a member of the following medical societies: Alliance for the Prudent Use of Antibiotics, Alpha Omega Alpha, American Association for the Advancement of Science, American Association of University Professors, American Clinical and Climatological Association, American College of Physician Executives, American College of Physicians, American Federation for Medical Research, American Foundation for AIDS Research, American Geriatrics Society, American Lung Association, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Association for Professionals in Infection Control and Epidemiology, Association of American Medical Colleges, Association of American Physicians, Association of Professors of Medicine, Infectious Disease Society for Obstetrics and Gynecology, Infectious Diseases Society of America, Louisiana State Medical Society, Orleans Parish Medical Society, Royal Society of Medicine, Sigma Xi, Society of General Internal Medicine, Southeastern Clinical Club, Southern Medical Association, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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