What is the cause of pyrexia (fever) of unknown origin?

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Differential Diagnosis for Fever of Unknown Origin

Single Most Likely Diagnosis

  • Infection: This is the most common cause of fever of unknown origin, with a wide range of possibilities including bacterial, viral, fungal, or parasitic infections. Justification: Infections are a common cause of fever, and many can present with non-specific symptoms, making them a likely culprit in cases of fever of unknown origin.

Other Likely Diagnoses

  • Connective Tissue Disease: Conditions such as rheumatoid arthritis, lupus, or vasculitis can cause prolonged fever. Justification: These diseases often present with systemic symptoms, including fever, and can be difficult to diagnose.
  • Malignancy: Certain types of cancer, such as lymphoma or leukemia, can cause fever. Justification: Malignancies can produce pyrogens, leading to fever, and may not always present with typical symptoms.
  • Medication-Induced Fever: Certain medications, such as antibiotics or anticonvulsants, can cause fever as a side effect. Justification: Many medications can induce fever, and this diagnosis should be considered, especially if the patient has recently started a new medication.

Do Not Miss Diagnoses

  • Endocarditis: This is a life-threatening infection of the heart valves that can present with fever and non-specific symptoms. Justification: Endocarditis has a high mortality rate if left untreated, making it a critical diagnosis to consider.
  • Tuberculosis: This infection can cause fever and non-specific symptoms, and is often difficult to diagnose. Justification: Tuberculosis is a serious infection that requires prompt treatment, and its diagnosis can be challenging.
  • Neutropenic Fever: This is a life-threatening condition that occurs in patients with a low white blood cell count, often due to chemotherapy or immunosuppression. Justification: Neutropenic fever requires immediate attention and treatment to prevent serious complications.

Rare Diagnoses

  • Familial Mediterranean Fever: This is a rare genetic disorder that causes recurrent episodes of fever and inflammation. Justification: This diagnosis is rare, but should be considered in patients with a family history of the condition.
  • Whipple's Disease: This is a rare bacterial infection that can cause fever, weight loss, and diarrhea. Justification: Whipple's disease is rare, but can be fatal if left untreated, making it an important diagnosis to consider.
  • Histiocytosis: This is a rare group of diseases characterized by an overproduction of histiocytes, which can cause fever and non-specific symptoms. Justification: Histiocytosis is rare, but can be serious, and its diagnosis requires a high index of suspicion.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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