Document 0209
 DOCN  M95A0209
 TI    Fever of uncertain origin in patients infected with the human
       immunodeficiency virus.
 DT    9510
 AU    Miralles P; Moreno S; Perez-Tascon M; Cosin J; Diaz MD; Bouza E;
       Department of Clinical Microbiology and Infectious Diseases,; Hospital
       General Gregorio Maranon, Madrid, Spain.
 SO    Clin Infect Dis. 1995 Apr;20(4):872-5. Unique Identifier : AIDSLINE
       MED/95315390
 AB    To assess the frequency and etiology of fever of uncertain origin (FUO)
       in patients infected with the human immunodeficiency virus (HIV) and to
       evaluate the yield of diagnostic procedures used in their evaluation, we
       reviewed the clinical charts of all patients admitted to an AIDS unit
       during a 15-month period. FUO was defined by the endurance of a fever
       (temperature, > 38.2 degrees C) for at least 4 weeks before admission
       and the uncertainty of diagnosis after 3 days, despite appropriate
       investigation. Of 580 patients evaluated, 50 (8.2%) had FUO. Patients
       with FUO were at advanced stages of HIV infection (median CD4+ cell
       count, 71/mm3), and a vast majority (84%) had previously diagnosed AIDS.
       A cause of the fever was identified for 44 patients (88%), and
       infections accounted for 82% of all cases. Tuberculosis (42%), visceral
       leishmaniasis (14%), and disseminated Mycobacterium avium complex
       infection (14%) were the most frequent diagnoses. Examination of lymph
       node aspirates, bone marrow biopsy, and culture of clinical specimens
       for mycobacteria were the procedures with the highest diagnostic yield.
       Among 6 patients with fever of no identified etiology, 4 died while
       febrile, and fever was self-limited in the other 2 patients. FUO is
       common among patients with advanced HIV infection. Since a cause,
       usually infection, can be identified in most patients, long-lasting
       fever should not be attributed to HIV itself.
 DE    Adult  Female  Fever of Unknown Origin/EPIDEMIOLOGY/*ETIOLOGY  Human
       HIV Infections/*COMPLICATIONS  Male  Middle Age  JOURNAL ARTICLE

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