OBJECTIVES: The aim of the study was to assess the incidence and aetiology of fever of unknown origin in human immunodeficiency virus (HIV)-infected patients, and to evaluate the usefulness of the main diagnostic procedures. DESIGN: A retrospective study. SETTING AND SUBJECTS: We reviewed the records of 270 HIV-infected patients who were hospitalized for the first time in a department of infectious and tropical diseases during the 27 month study period. MAIN OUTCOME MEASURES: Fifty-seven patients (21%) had a history of fever of unknown origin. RESULTS: The aetiology was found in 49 cases (86%). The major cause of the fever was mycobacteriosis: atypical mycobacteria in 10 cases, Mycobacterium tuberculosis in 10, mycobacteria of unspecified type in two, and BCG strain in one. A liver biopsy and a thoracic CT scan greatly contributed to the diagnosis of mycobacterial infection. Seventeen patients were given empiric antimycobacterial therapy as a therapeutic test, of whom seven had a favourable response. The other main causes of fever were cytomegalovirus infection in five patients, leishmaniasis in four, and lymphoma in four. CONCLUSIONS: Fever of unknown origin is a frequent occurrence in the course of HIV infection, and mycobacterial infection should be considered as a first-line diagnosis in such cases. The place of empiric antimycobacterial therapy in the diagnostic strategy requires further evaluation, but appears to be an alternative to multiple investigative procedures.
OBJECTIVES: The aim of the study was to assess the incidence and aetiology of fever of unknown origin in human immunodeficiency virus (HIV)-infectedpatients, and to evaluate the usefulness of the main diagnostic procedures. DESIGN: A retrospective study. SETTING AND SUBJECTS: We reviewed the records of 270 HIV-infectedpatients who were hospitalized for the first time in a department of infectious and tropical diseases during the 27 month study period. MAIN OUTCOME MEASURES: Fifty-seven patients (21%) had a history of fever of unknown origin. RESULTS: The aetiology was found in 49 cases (86%). The major cause of the fever was mycobacteriosis: atypical mycobacteria in 10 cases, Mycobacterium tuberculosis in 10, mycobacteria of unspecified type in two, and BCG strain in one. A liver biopsy and a thoracic CT scan greatly contributed to the diagnosis of mycobacterial infection. Seventeen patients were given empiric antimycobacterial therapy as a therapeutic test, of whom seven had a favourable response. The other main causes of fever were cytomegalovirus infection in five patients, leishmaniasis in four, and lymphoma in four. CONCLUSIONS:Fever of unknown origin is a frequent occurrence in the course of HIV infection, and mycobacterial infection should be considered as a first-line diagnosis in such cases. The place of empiric antimycobacterial therapy in the diagnostic strategy requires further evaluation, but appears to be an alternative to multiple investigative procedures.
Authors: F Lozano; J Torre-Cisneros; A Bascuñana; J Polo; P Viciana; M A García-Ordóñez; J Hernández-Quero; M Márquez; A Vergara; F Díez; E Pujol; M Torres-Tortosa; J Pasquau; J J Hernández-Burruezo; I Suárez Journal: Eur J Clin Microbiol Infect Dis Date: 1996-09 Impact factor: 3.267
Authors: J Alvar; C Cañavate; B Gutiérrez-Solar; M Jiménez; F Laguna; R López-Vélez; R Molina; J Moreno Journal: Clin Microbiol Rev Date: 1997-04 Impact factor: 26.132
Authors: D K Lewis; Rph Peters; M J Schijffelen; Grf Joaki; A L Walsh; J G Kublin; J Kumwenda; S Kampondeni; M E Molyneux; E E Zijlstra Journal: Malawi Med J Date: 2003-06 Impact factor: 0.875