PUO

Question 1

What is the diagnostic criteria for PUO?

Answer 1

Pyrexia for more than 3 weeks with no identified cause after evaluation in hospital 3 days or 3 or more outpatient visits

Question 2

What are nosocomial PUO, immunodeficient PUO, HIV PUO

Answer 2

Nosocomial - pyrexia started in hospital after being in after 42 hours
Immunodeficient - pyrexia and neutrophils below 500/microlitre
HIV - pyrexia in HIV lasting 3 days as in patient or more than 4 weeks as an outpatient

Question 3

What is important in a PUO history?

Answer 3

Most likely something atypical so take everything as important. Consider travel. diet, animals, food, medication (and any changes), drug use, obstetrics and sexual history, family history

Question 4

What is important in a PUO examination?

Answer 4

Confirm fever and check pattern.

Check mouth, genitals, skin, thyroid, lymphatic system, eyes and temporal arteries.

Question 5

What is important in PUO investigations?

Answer 5

Blood tests - FBC, U&Es, LFT, CRP, ESR, LDH, auto-antibodies, HIV test, malaria smear, interferon gamma assay