Fever of Unknown Origin in a Bulgarian Hospital: Evaluation of 54 Cases for a Four Year-Period

Abstract

Aim: The aim of this study was to describe the etiological distribution, clinical and laboratory characteristics of patients with Fever of unknown origin (FUO), admitted to one Bulgarian hospital. Material and Method: A retrospective study was done for a period of four years. The modified criteria of Petersdorf and Beeson were applied. Complete history, physical examination and basic laboratory investigations were done. According to the potentially diagnostic clues, specific tests, immunological and imaging methods were performed. The invasive procedures were the last step. Results: Fifty-four patients met the inclusion criteria. The estimated causes were: infection 59.3%, neoplasm 3.7%, non-infectious inflammatory disease 14.8%, miscellaneous 5.5% and undiagnosed cases 16.7%, respectively. The mean age was 44.3 years. The leading clinical features were fever, chills, sweats and fatigue. The association of clinical signs, physical exam and laboratory results were discussed. Discussion: The infectious diseases were the leading cause of FUO. The etiological distribution of causes was near to results reported from South-East Europe. Some geographic, climatic, zoonotic and social factors influenced the results.