Day #70 - Fever of Unknown Origin III

I missed the rounds -- but have discussed pyrexia of unknown origin twice before. #1 and #2. Probably not as good as the discussant, but I referenced the article they were referring to.

"Special Guest Blog" by the discussant:

• Even in the "modern era", up to 1/3 of cases may go undiagnosed -these cases carry a good prognosis.
• Infections only account for 1/4 of all diagnoses.
• In certain cases without diagnosis, the benefits of liver biopsy outweigh the risks.
• Bone marrow cultures are of low diagnostic yield. Bone marrows should be performed only when there are other indications to do so ie unexplained cytopenias.
• I recently cared for a patient with FUO whose Hodgkin's disease was diagnosed on liver biopsy alone. Patients with FUO are challenging to investigate, are rewarding by virtue of the enigmatic causes that are may be found and reinforce the importance of basic principles like the careful history and physical examination.