Nosocomial fever of unknown origin

This study described the demographics, etiology, and prognosis of nosocomia l fever of unknown origin (FUO) using a retrospective study design. The stu dy sites included a university-controlled, tertiary referral teaching hospi tal, a university-associated Veterans Administration Hospital, and a large tertiary referral private hospital. The subjects included 141 patients with nosocomial FUO, which was defined as (1) fever greater than or equal to 38 .3 degrees C on three or more occasions in a hospitalized patient receiving short-term care; (2) infection not present or incubating on admission; and (3) uncertain diagnosis after 3 days despite appropriate investigation, in cluding at least a 2-day incubation of microbiologic cultures. The average age of the study subjects was 57.1 +/- 17.9 years; men represented 63.8%, a nd 65.8% had undergone surgery within 30 days before the infectious disease s (ID) consultation. Average fever duration was 15.7 +/- 14.1 days. The mai n causes of nosocomial FUO were infection (34.8%) and drug fever (17.0%). U ndiagnosed cases constituted 22.7% of the patients studied. At last follow- up, 83% of the patients were alive, 8.5% were dead due to other causes, and 8.5% were dead presumably due to nosocomial FUO. Nosocomial FUO is a preva lent medical problem and a relatively frequent cause of ID consultation. A timely diagnosis of the cause of nosocomial FUO can potentially save lives and shorten hospitalization time.