[Fever of Unknown Origin in children and adolescents in Georgia: a review of 52 patients]

Abstract

The distribution of the disorders causing Fever of Unknown Origin (FUO) may differ according to the geographic area and the socioeconomic status of the country. FUO has not been appropriately investigated in children and adolescents in Georgia and therefore a study was undertaken to determine its causes and clinical characteristics. A total of 52 children fitting the classical FUO criteria seen in our clinic between 2003 and 2005 were investigated retrospectively. 27 (51,9 %) were boys and 25 (48,0%) were girls. 3 children (5,7 %) were less than 3 years old, 4 (7,6%) were 3-9 years old, 14 (26,9 %) were 10-14 years old and 32 (61,5%) were 15-18 years old. The mean age was 15,9 +/-4,8 years (range 1 year-18 years). 25 children (48,0 %) had a prolonged fever that had lasted for 15-30 days, 15 (28.8 %) for 31-60 days, and 12 (23.0 %) had fever lasting for more than 60 days. The most common causes of FUO were sepsis (10/52), tuberculosis (9/52), pneumonia (8/52), pyelonephritis (5/52), collagen tissue disorder (2/52), neoplasm (2/52), and miscellaneous (9/52). In 7 (13,4 %) of the cases the etiology could not be found. Some derivative hematological parameters--leukocytic index of intoxication, organism's allergisation index, ratios lymphocytes/neutrophils and eosinophils/lymphocytes and adaptation reactions can be helpful to distinguish severe infections. Precise evaluation of hematological changes can be useful for differential diagnosis of FUO. The most common cause of FUO in children and adolescents in Georgia remains infection.