Why is prolonged fever often difficult to diagnose?

Prolonged smoldering fever is often difficult to determine the exact cause. In case of prolonged fever are tuberculosis, pericarditis, osteomyelitis, in-abdominal absculsion, colon cancer,… it is difficult to detect for timely treatment, which can cause many dangerous complications for patients.

1. Learn about unsym cause-prolonging fever

1.1 What is prolonged fever of unknown cause?

Fever of unknown origin (FUO) is a term used to address a condition where a patient has an increased temperature (fever) but cannot find a specific cause. This condition is determined based on the following characteristics: the temperature is higher than 38.3°C (101°F), the fever period is more than 3 weeks, and the exact cause cannot be found after a week of hospitalization.

Unsymed fever is classified into 4 categories:

  • Fever of unknown classical causes;
  • Unsymed fever at the hospital;
  • Unsymed fever associated with HIV infection;
  • Fever of unknown causes of neuino leukocytics.

1.2 Characteristics of unsoper cause-prolonging fevers

Fever of unknown classical causes

  • Due to infection: Tumors, tuberculosis, endoratitis and urinary tract infections have complications;
  • Due to connective tissue pathology: Arthritis and polymematitis, otitis media, systemic lupus erythematosis, Still disease and rheumatoid arthritis;
  • Due to the appearance of neo neomas: lymphoma, acute and chronic leukocytes;
  • Drug-in-class: Side effects after the use of antibiotics, cardiovascular drugs, anti-cancer drugs or drugs that act on the central nervous system;
  • Due to other disorders: Granuloma pathology, alcoholic hepatitis;
  • Due to other undiagnosed conditions.

Young chocolate

Patients may have prolonged fever if they have an infection

Unsym cause fever in hospital

Fever in hospitalized patients for a minimum period of 24 hours. The causes of fever are usually:

  • Influenced by surgery, the use of urethral and urinary catheters, medical instruments placed in cardiovascular diseases such as coronary stents, bridge catcher, pulmonary artery catheter;
  • Effects from the use of the drug (clostridium difficile colitis fever due to antibiotics);
  • Fever due to the appearance of ulcers because the position is lying down for too long;
  • Placing sonde in the stomach through the pharynx and stomach can cause sinusitis and cause prolonged fever symptoms;
  • Other causes of prolonged fever in the hospital: Venous inflammation caused by deep vein intravenous, pulmonary embolism, stone-free gallbladder inflammation, thyroiditis, post-withdrawal and alcohol withdrawal reactions, infusion reactions, acrostatic ins depletion and pancreatitis.

Fever of unknown causes of neuinophremia

Patients with leukocysis are more susceptible to fungal, bacterial infections (Candida and Aspergillus, Herpes simplex virus,…) that cause infection and present with prolonged fever.

Unsymed fever linked to HIV/AIDS infection

  • HIV infection is the cause of fever;
  • Factors for hiv-associated fever include: Mycobacterium intracellulare, Mycobacterium avium, P.carinii, tuberculosis, Salmonella, Toxoplasma, Cryptococcus, non-Hodgkin lymphoma;
  • Drug-in-medicine fever.

HIV young children

HIV infection is the cause of fever

2. Symptoms of prolonged fever

  • Symptoms of fever with different types of fever: Constant high fever, fluctuating high fever, fever, tremor malaria, mild afternoon fever, cyclical fever, erratic fever, recurrent fever,…;
  • Symptoms of fever-causing disease: Manifestations of intoxication, hemorrhage, jaundice, anemia, enlarged liver, enlarged spleen, lymphadenopathy, rash, bone pain, joint pain, skin lesions, abdominal pain, diarrhea, urinary disorders, cough, shortness of breath,… These symptoms are oriented towards the cause of the disease;
  • Symptoms affecting the whole condition: Loss of appetite, fatigue, dehydration, digestive disorders, electrolysm disorders, weight loss, malnutrition, psychological disorders,…

3. Prolonged fever is often difficult to diagnose

The diagnosis of prolonged causes of fever in children and adults is important for treatment. However, the cause of prolonged fever is often difficult to diagnose because:

  • There are many conditions that cause prolonged fever symptoms. In many cases, only fever is a pronounced symptom of the disease. Therefore, the correct diagnosis of the cause of fever is difficult and takes a long time. Most often, prolonged fever is most common in infectious diseases, in addition to being seen in many medical diseases;
  • Diagnostic distracting factors such as antibiotics overshadow typical disease or drug-inquenial fever that can increase leukocytity,…;
  • There are some cases of fake fever, patients with various uses have faked fever by rubbing thermometers for heat, dipping thermometers in warm water, burning cigarette butt heads,…;

There are many cases of prolonged fever that do not find the cause of the disease despite being monitored in conditions with modern medical equipment, applied many subclinical diagnostic measures, hospitalized for months.

4. Prolonged method of diagnosis of fever

jail

A traditional clinical examination is one of the methods of prolonged diagnosis of fever
  • Thoroughly exploit the patient's history and history: Age, duration of symptoms, feverish nature, symptoms accompanying fever, patient's medical history, family history, epidemiology of living area, history of medications and other treatments;
  • Physical examination with a system: Temperature monitoring every 3 hours (when false fever is suspected should monitor temperature for identification), assess the manifestations of the disease, find physical and general symptoms to guide the diagnosis;
  • Symptomatic evaluation of the disease: Infectious syndrome, intoxication (anesthies, toothache, pneumonia, urinary tract inflammation, hepatitis,…); specific signs of micro-ants (malaria, tuberculosis, typidal, EBV infection,…); HIV (fever lasts more than 2 months with symptoms of fatigue, weight loss, hepatic enlarged, enlarged spleen, lymphadenopathy, inflammation of the ear glands, prolonged or recurrent diarrhea); malignanty (tumors, severe anemia, hepatic enlarged, enlarged spleen, lymphadenopathy, hemorrhage,…); autoimetic diseases (cyclic or recurrent fever, painful swelling of the joints, recurrent rashes, impaired function of the heart, liver, kidneys,…); genetic diseases, conversion disorders or other diseases,…;
  • Initial test in which: Basic test for diagnostic access (blood formula, blood deposition rate, blood culture, urine analysis, urine transplantation, mesentery implantation, thoracic X-ray); tests to assess complications caused by the disease (electrolyses, liver function, renal function, respiratory and resular function,…); ed-ed orientation tests (microorganisms, myeloma, anatomy); imaging (ultrasound, X-rays, computer cts, resym resonance imaging,…); biopedes if the above surveys have not diagnosed the cause of prolonged fever.

5. Prolonged fever treatment

Replenish your body with enough water

Patients with prolonged fever often have a lack of water, so they need to replenish about 2-3 liters of water/day

Active, comprehensive and preventable treatment of serious complications of the disease due to complications that can be fatal before a prolonged diagnosis of the cause of fever is required. Some issues to keep in mind when caring for and treating patients with prolonged fever are:

  • Should I lower the fever? Fever is a reaction that helps the body fight infections, protect the body. On the other hand, the use of antipyretics can cause blood damage, reduce the body's immunity and resistance to pathogens, overshadowing the typical disease, making it difficult to diagnose. However, in certain cases, especially in children, too high a fever can cause seizures. Therefore, caregivers can take physical measures such as using a fan, applying warmth, avoiding wearing a lot of clothes and using hypothermia, antivulsive drugs for patients as prescribed by a doctor;
  • Replenish enough water: Patients with prolonged fever often have a lack of water, so it is necessary to replenish about 2-3 liters of water per day until the amount of urine discharged reaches 1 liter / day. Replenishing enough res resory water will help the body reduce heat more effectively;
  • Eat enough substances: People with prolonged fever often suffer from digestive disorders (loss of appetite, vomiting, diarrhea, constipation,…) causing rapid thinness due to protein in the organizations consumed. The higher the fever, the higher the protein demand, so it is necessary to ensure that the patient eats enough 2,100 – 3,000 Kcal / day. Patients should be fed in several meals, prioritizing dishes that suit the patient's taste;
  • For patients to be active, sit in a chair for several hours a day, do not be absolutely unable to avoid causing blockage due to blood clotting;
  • After collecting sufficient data on his/her medical history, medical conditions, symptoms and tests, although there is no accurate diagnosis, it is possible to consider trial treatment for patients with edict treatment drugs or mechanisms such as anti-tuberculosis, antimalarial, antibiotic, anti-inflammatory drugs,… but it is necessary to avoid indiscriminate and hasty use as it may make it difficult to diagnose and treat later.

Prolonged fever can be a warning sign of many dangerous diseases. Therefore, when there are symptoms of long-term fever that do not cure, recur many times, the patient should soon go to the doctor for an accurate diagnosis and have the appropriate treatment direction.

For detailed advice on the disease, please go directly to Vinmec health system or book an online visit HERE.

SEE MORE:

  • What is prolonged fever in a child? How should I handle it?
  • Distinguish between common fever, viral fever and dengue
  • How long does viral fever in adults last? Do you need to go to the hospital?

SEE MORE:

  • Prolonged fever of unknown reasons: When to go to the doctor?
  • What to know about the drug for osteoarthritis
  • Is it okay to have a postoperative fever for osteoarthritis?

About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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