Koorts van ongekende oorsprong: het systematisch ontrafelen van een diagnostisch kluwen

Abstract

Fever of unknown origin: diagnostic approach by means of a case Fever of unknown origin presents a diagnostic challenge to every clinician. Over 200 causes are reported in the literature, often concerning uncommon presentations of well­known diseases. A diagnostic algorithm can provide the necessary guidance to approach this complex disease on a correct, efficient and cost­effective base. The working out starts with a correct definition: fever of unknown origin is a feverish illness with a duration of at least three weeks, hallmarked by fever higher than 38.3 °C on several occasions and with an uncertain cause after performing a set of minimal diagnostic exams. The further assessment comprises the exploration of „potential diagnostic hints”, performance of additional imaging studies (CT scan or FDG­PET/CT) and repeating the same basic investigations. Empirical therapy is reserved for patients with clinical deterioration. Overall mortality, however, is low.