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A male doctor in a white coat talks to a male patient in a blue t-shirt in an examination room.

A male doctor in a white coat talks to a male patient in a blue t-shirt in an examination room.
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Systematic Approach to Fever of Unknown Origin Evaluation Step 1: Comprehensive History and Physical Examination to identify any potential diagnostic clues for underlying illnesses. Step 2: a.) Order appropriate tests if potential diagnostic clues are present; or b.) Order minimal standard investigations if potential diagnostic clues are absent. Step 3: Objectively verify fevers in patients without symptoms or signs of chronic illness (i.e., anemia, elevated inflammatory markers) Step 4: a.) If the patient meets FUO criteria, then consider early use of FDG-PET/CT; or b.) If the patient does not meet FUO criteria, refer patient to an expert center for further evaluation Step 5: a.) If early use of FDG-PET/CT reveals potential diagnostic clues, then order appropriate investigations; or b.) If early use of FDG-PET/CT does not reveal potential diagnostic clues, then repeat comprehensive history and physical examination Step 6: a.) If repeat comprehensive history and physical examination reveals potential diagnostic clues, then order appropriate tests; or b.) If repeat comprehensive history and physical examination does not reveal any potential diagnostic clues, and the patient remains ill without a diagnosis other then FUO discuss empirical treatments (i.e., empirical antimicrobial therapy, corticosteroids, and/or anti-inflammatory agents) See more

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