- Incidence and risk factors of fever in a contemporary cohort of HIV-patients with good access to antiretroviral therapy. [Journal Article]
- ACActa Clin Belg 2017; 72(4):226-231
- CONCLUSIONS: In this contemporary cohort, incidence of fever was low but CD4 cell count less than 200/mm³ remained associated with the highest incidence of fever.
- Utility of bone marrow examination for workup of fever of unknown origin in patients with HIV/AIDS. [Journal Article]
- JCJ Clin Pathol 2015; 68(3):241-5
- CONCLUSIONS: This study supports the use of diagnostic BMAB as a rapid decision-making tool in patients with HIV and FUO in the proper clinical setting. BMAB demonstrated infection-related evidence prior to positive bone marrow culture in 75% of cases. Special stains and blood cultures had similar diagnostic yield, but BMAB offers faster results. Thus, this procedure assists in clinical decision making and the refinement of treatment in a more timely manner.
- Analysis of 256 cases of classic fever of unknown origin. [Journal Article]
- IMIntern Med 2014; 53(21):2471-5
- CONCLUSIONS: FUO associated with HIV/AIDS is increasing in Japan. In addition, as in previous studies in Japan and overseas, our study showed that the number of patients in whom the cause of FUO remains unknown is increasing and exceeds 20% of all cases. The present study identified diseases that should be considered in the differential diagnosis of FUO, providing useful information for the future diagnosis and treatment of FUO.
- Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study. [Journal Article]
- BOBMJ Open 2013; 3(12):e003971
- CONCLUSIONS: With the widespread use of CT, FUO due to deep-seated abscess or solid tumour is decreasing markedly. Owing to the influence of the ageing population, polymyalgia rheumatica was the most frequent cause (9 patients). Four patients had FUO associated with HIV/AIDS, an important cause of FUO in Japan. In a relatively small number of cases, cause remained unclear. This may have been due to bias inherent in a retrospective study. This study identified diseases that should be considered in the differential diagnosis of FUO.
- Fever in HIV-infected patients: less frequent but still complex. [Review]
- ACActa Clin Belg 2012 Jul-Aug; 67(4):276-81
- Fever was a common symptom in patients with Human Immunodeficiency Virus (HIV) infection in the early phases of the epidemic. Fever of Unknown Origin (FUO) was frequent in HIV-patients and conditions...
Fever was a common symptom in patients with Human Immunodeficiency Virus (HIV) infection in the early phases of the epidemic. Fever of Unknown Origin (FUO) was frequent in HIV-patients and conditions causing FUO were often opportunistic conditions. The HIV-epidemic continues to expand, but access to effective antiretroviral therapy is also expanding, resulting in a growing number of HIV-infected patients less likely to be severely immunocompromised and less likely to present opportunistic conditions. Yet part of newly diagnosed patients continue to present with advanced HIV-infection and are still at high risk of opportunistic conditions. This epidemiological evolution strongly influences the spectrum of conditions causing fever and FUO in HIV-patients. While some patients with HIV-associated fever and FUO may still be suffering from opportunistic conditions classically associated with HIV-related FUO, many others will have causes of fever that are similar to the non-HIV-infected population or to classical FUO. Strategies for diagnosis and treatment of fever and its causes in HIV-infected patients need to take into account this evolution.
- High FDG uptake on FDG-PET scan in HIV-1 infected patient with advanced disease. [Case Reports]
- ACActa Clin Belg 2011 Nov-Dec; 66(6):419-21
- CONCLUSIONS: in patients with advanced HIV infections presenting with FUO, high uptake in 18FDG-PET-CT can be the marker of advanced disease reflecting the areas of viral replication.
- Diagnostic yield of bone marrow examination in HIV associated FUO in ART naïve patients. [Journal Article]
- JIJ Infect Public Health 2010; 3(3):124-9
- A bone marrow (BM) aspiration and biopsy is often believed to be a much needed diagnostic procedure in the work up of patients with fever of unknown origin (FUO), especially in the setting of AIDS. I...
A bone marrow (BM) aspiration and biopsy is often believed to be a much needed diagnostic procedure in the work up of patients with fever of unknown origin (FUO), especially in the setting of AIDS. Is it worthwhile to proceed with this invasive diagnostic method? The usefulness of a BM aspiration or biopsy to assist in the diagnosis of FUO or prolonged fever in AIDS patients has been reported previously to range from 4% to 40%. The purpose of this study was to assess the usefulness of a BM aspiration and biopsy in diagnosing the cause of FUO in patients with AIDS and to identify the utility of the procedure for the diagnosis of malignancies/other hematological disorders resulting in the FUO. In this study, comprising of 30 patients, we have tried to find the diagnostic yield of bone marrow examination in finding the etiology of "FUO associated with HIV infection". Though similar studies have been reported in the literature but it is lacking from eastern India. The majority of BM examination in this series revealed infections followed by hematological disorders. Our study showed the diagnostic yield of bone marrow examination in "HIV associated FUO" to be 26.7%. It was found to be positive in 33.3% of the patients, who had the final diagnosis of an infective etiology and 100% of the patients, who had a final diagnosis of an underlying hematological etiology.
- Evolution of the incidence and aetiology of fever of unknown origin (FUO), and survival in HIV-infected patients after HAART (Highly Active Antiretroviral Therapy). [Journal Article]
- EJEur J Intern Med 2009; 20(5):474-7
- CONCLUSIONS: Our results confirm that the incidence of FUO has significantly decreased with the introduction of HAART. HAART has also transformed the aetiological spectrum related to FUO considerably. The most frequent cause of FUO in non-HAART patients on this study was the disseminated infection by Mycobacterium avium intracellulare (MAI), followed by tuberculosis, while leishmaniasis was its most common cause in patients receiving HAART. Survival decreased in patients who developed FUO; however, patients who received HAART at the time of FUO had longer survival than patients who did not.
- Fever of unknown origin in patients with HIV infection in Thailand: an observational study and review of the literature. [Journal Article]
- IJInt J STD AIDS 2008; 19(4):232-5
- Fever of unknown origin (FUO) is a common presentation for patients with advanced human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). We prospectively followe...
Fever of unknown origin (FUO) is a common presentation for patients with advanced human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). We prospectively followed 72 patients, consecutively admitted to a Thai regional hospital with FUO and HIV infection to identify aetiologies and mortality in the era of available antiretroviral therapy (ART). Aetiologies of FUO were identified in 67 patients (93%), of whom 61(85%) had an infectious aetiology. The most common infectious aetiologies were Mycobacterium tuberculosis (n=30; 42%), Cryptococcus neoformans (n=17; 24%), Pneumocystis jiroveci (n=9; 13%), Toxoplasma gondii (n=5; 7%), and salmonella bacteraemia (n=5; 7%). Nineteen patients (26%) had co-infection with two or more pathogens. The median CD4 count was 120 cells/mm(3) (range, 1-581 cells/mm(3)), and the all-cause mortality was 22% (n=16). By multivariate analysis, inadequate antimicrobial treatment was the sole predictor of mortality (aOR=4.9; 95% CI=1.2-21.9; P=0.02). Overall, 58 of 72 patients (81%) had an opportunistic infection suggesting that guideline use of ART and prophylactic strategies remain unmet needs that will benefit individuals and populations with HIV/AIDS in Thailand.
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- Fever of unknown origin in HIV/AIDS patients. [Review]
- IDInfect Dis Clin North Am 2007; 21(4):1013-32, ix
- Fever of unknown or uncertain origin (FUO) constitutes a common clinical challenge in patients infected with HIV. It is usually caused by disseminated opportunistic infection, and the relative freque...
Fever of unknown or uncertain origin (FUO) constitutes a common clinical challenge in patients infected with HIV. It is usually caused by disseminated opportunistic infection, and the relative frequency of each cause of FUO is influenced by multiple factors including CD4 count, geographic setting, and local prevalences of infectious agents, which may provide clues to the diagnosis. Infections presenting as FUO in the HIV population occur most often in the late stages of the disease and high diagnostic suspicion for mycobacterial disease should be maintained when evaluating these patients, particularly in areas of high prevalence. This article discusses the causes, diagnosis, and treatment of FUO in HIV-infected individuals.