Fever of Unknown Origin (FUO) Diagnostic Algorithm
STEP ...

Fever of Unknown Origin (FUO) Diagnostic Algorithm
STEP 1 Perform a comprehensive history and complete physical examination.
STEP 2 PDCs identified? Apply appropriate invasive or noninvasive diagnostic studies for investigation
Order CBC, CMP, ESR, CRP, ferritin, TSH, RF, ANA, HIV-1/2 serology, hepatitis A, B, and E, urinalysis with microscopy, tuberculosis skin test or TB whole-blood interferon-γ releasing assay, blood cultures × 3, venous duplex imaging of the lower extremities, CT of chest and abdomen/pelvis, and echocardiography (TTE/TEE).
STEP 4 Any positive first-tier testing? 
STEP 5 Any PDCs by repeat history and physical examination? 
STEP 6 Order 18FDG-PET/CT scan imaging (if not already performed).
STEP 7 If there are still no new PDCs then re-evaluate the patient history and physical examination periodically. Continue to monitor any new PDCs and apply appropriate noninvasive and/or invasive diagnostic testing based upon any new findings. At this stage, empiric use of nonsteroidal anti-inflammatory agents or immunosuppressant therapy such as corticosteroids could be entertained after discussing risks and benefits with the patient.


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Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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