Fever of unknown origin in patients infected with the human immunodeficiency virus

To describe the clinical features and the final diagnosis of patients infected with human immunodeficiency virus who presented fever of unknown origin. Retrospective study, from November 1989 to January 1994, of all patients infected with HIV who had fever of unknown origin and who were admitted to...

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Published inRevista clínica espanõla Vol. 196; no. 1; p. 4
Main Authors Carbonell Biot, C, Ena Muñoz, J, Pasquau Liaño, F, Badía Ferrando, P, Ortiz de Salazar Martín, A, Vilar Zanón, A
Format Journal Article
LanguageSpanish
Published Spain 01.01.1996
Subjects
Adult
Aged
Female
Fever of Unknown Origin - etiology
HIV Seropositivity - complications
Humans
Male
Middle Aged
Retrospective Studies
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Summary:To describe the clinical features and the final diagnosis of patients infected with human immunodeficiency virus who presented fever of unknown origin. Retrospective study, from November 1989 to January 1994, of all patients infected with HIV who had fever of unknown origin and who were admitted to a community hospital in a Mediterranean area in Alicante (Spain). Fever of unknown origin was defined as fever exceeding 38.3 degrees C lasting for at least three weeks with no diagnosis in the first three days of hospitalization after fulfilling clinical exam, three blood cultures, acid-fast bacilli stain in sputum and chest-X-ray. Of a cohort of 231 patients, 27 (12%) were evaluated because of fever of unknown origin during their follow-up. Patients' mean age was 31 years (interval, 22-75) and intravenous drug use (81%) was the most common risk factor for HIV infection. A total of 31 episodes of fever of unknown origin were reviewed. Twenty-three (74%) episodes occurred in patients with less than 200 CD4 lymphocytes/mm3. A final diagnosis of fever of unknown origin was achieved in 24 (77%) episodes: visceral leishmaniasis (n = 11), tuberculosis (n = 9), non-Hodgkin's lymphoma (n = 1), CNS toxoplasmosis (n = 1), cryptococcal meningitis (n = 1) and drug adverse reaction (n = 1). HIV-infected patients with fever of unknown origin very often show severe immunodeficiency. Cryptococcal antigen testing should be carried out in the initial evaluation of fever of unknown origin in HIV-infected patients. In our area, 64% of episodes of fever of unknown origin were caused by visceral leishmaniasis or tuberculosis.
ISSN:0014-2565