Chapter 019. Fever of Unknown Origin (Part 3) Source: From a study of 347 patients referred to the National Institutes of Health from 1961 to 1977 with a presumptive diagnosis of FUO of >6 months' duration (R Aduan et al. Prolonged fever of unknown origin . Clin Res 26:558A, 1978). More than 200 conditions may be considered in the differential diagnosis of classic FUO in adults; the most common of these are listed in Table 19-3. This list applies strictly to the United States. Geographic considerations are paramount. For example, in Japan, human T cell lymphotropic virus type I is a consideration; in China, infection plays a greater role and tuberculosis is prominent; and in Spain, visceral leishmaniasis may be a more common cause of FUO. The frequency of global travel underscores the need for a detailed travel history, and the continuing emergence of new infectious diseases makes this listing potentially incomplete. The possibility of international and domestic terrorist activity involving the intentional release of infectious agents, many of which cause illnesses presenting with prolonged fever, underscores the need for obtaining an insightful environmental, occupational, and professional history, with early notification of public health authorities in cases of suspicious etiology (Chap. 214). Table 19-3 Causes of FUO in Adults in the United States Infections Localized pyogenic infections Appendicitis Cat-scratch disease Cholangitis Cholecystitis Dental abscess Diverticulitis/abscess Lesser sac abscess Liver abscess Mesenteric lymphadenitis Osteomyelitis Pancreatic abscess Pelvic inflammatory disease Perinephric/intrarenal abscess Prostatic abscess Renal malacoplakia Sinusitis Subphrenic abscess Suppurative thrombophlebitis Tuboovarian abscess Intravascular infections Bacterial aortitis Bacterial endocarditis Vascular catheter infection Systemic bacterial infections Bartonellosis Brucellosis Campylobacter infection Cat-scratch disease/bacillary angiomatosis (B. henselae) Gonococcemia Legionnaires' disease Leptospirosis Listeriosis Lyme disease Melioidosis Meningococcemia Rat-bite fever Relapsing fever Salmonellosis Syphilis Tularemia Typhoid fever Vibriosis Yersinia infection Mycobacterial infections M. avium/M. intracellulare infections Other atypical mycobacterial infections Tuberculosis Other bacterial infections Actinomycosis Bacillary angiomatosis Nocardiosis Whipple's disease Rickettsial infections Anaplasmosis Ehrlichiosis Murine typhus Q fever Rickettsialpox Rocky Mountain spotted fever Mycoplasmal infections Chlamydial infections Lymphogranuloma venereum Psittacosis TWAR (C. pneumoniae) infection Viral infections Colorado tick fever Coxsackievirus group B infection Cytomegalovirus infection Dengue Epstein-Barr virus infection Hepatitis A, B, C, D, and E Human herpesvirus 6 infection Human immunodeficiency virus infection Lymphocytic choriomeningitis Parvovirus B19 infection Fungal infections Aspergillosis Blastomycosis Candidiasis Coccidioidomycosis Cryptococcosis Histoplasmosis Mucormycosis Paracoccidioidomycosis Pneumocystis infection Sporotrichosis Parasitic infections Amebiasis Babesiosis Chagas' disease Leishmaniasis Malaria Strongyloidiasis Toxocariasis Toxoplasmosis Trichinosis Presumed infections, agent undetermined Kawasaki's disease (mucocutaneous lymph node syndrome) Kikuchi's necrotizing lymphadenitis Neoplasms Malignant Colon cancer Gall bladder carcinoma Hepatoma Hodgkin's lymphoma Immunoblastic T-cell lymphoma Leukemia Lymphomatoid granulomatosis Malignant histiocytosis Non-Hodgkin's lymphoma Pancreatic cancer Renal cell carcinoma Sarcoma Benign Atrial myxoma Castleman's disease Renal angiomyolipoma Habitual Hyperthermia (Exaggerated circadian rhythm) [...]... polychondritis Rheumatic fever Rheumatoid arthritis Schnitzler's syndrome Systemic lupus erythematosus Takayasu's aortitis Weber-Christian disease Wegener's granulomatosis Granulomatous Diseases Crohn's disease Granulomatous hepatitis Midline granuloma Sarcoidosis Miscellaneous Conditions Aortic dissection Drug fever Gout Hematomas Hemoglobinopathies Laennec's cirrhosis PFPA syndrome: periodic fever, adenitis,... cold urticaria Familial Mediterranean fever Hyperimmunoglobulinemia D and periodic fever Muckle-Wells syndrome Tumor necrosis factor receptor–associated periodic syndrome Type V hypertriglyceridemia Thermoregulatory Disorders Central Brain tumor Cerebrovascular accident Encephalitis Hypothalamic dysfunction Peripheral Hyperthyroidism Pheochromocytoma Factitious Fevers "Afebrile" FUO ( . Chapter 019. Fever of Unknown Origin (Part 3) Source: From a study of 347 patients referred to the National Institutes of Health from 1961 to 1977 with a presumptive diagnosis of FUO of. al. Prolonged fever of unknown origin . Clin Res 26:558A, 1978). More than 200 conditions may be considered in the differential diagnosis of classic FUO in adults; the most common of these are. The possibility of international and domestic terrorist activity involving the intentional release of infectious agents, many of which cause illnesses presenting with prolonged fever, underscores