Abstract
Fever of unexplained (or unknown) origin (FUO) remains a relevant clinical problem
even with modern diagnostic methods. In addition to the classical definition, new
categories of FUO describe different clinical situations: nosocomial FUO, FUO in neutropenic/immundeficient
patients and FUO in patients with HIV-infection. The new categories are defined by
much shorter duration of fever, i. e. mostly three days. Each category of FUO shows
a different spectrum of infectious diseases. Often, subacute bacterial endocarditis
is very difficult to verify. In many cases, patients in intensive care suffer from
FUO caused by reactivation of CMV. In patients with HIV the most important diagnostic
indicator concerning the origin of infection is the degree of immundeficiency. Biological
and nuclear medical (PET-CT) verification procedures have been established in diagnostics.
A national or international register should be created with the purpose of data transfer
and validation of strategies concerning the treatment of FUO.
Fieber ungeklärter Ursache ist kein Syndrom, sondern ein klinisches Problem. Prinzipiell
ist hier nicht der Spezialist, sondern der Generalist gefragt: Die Differenzialdiagnosen
wie auch die Behandlung erfordern breites klinisches Denken, Wissen und Erfahrung.
Andererseits sind bei infektiösen Ursachen wiederum spezifische Kenntnisse und Vorgehensweisen
notwendig.
Schlüsselwörter
Fieber unklarer Genese - nosokomiale Infektionen - Infektionen bei immunkompromittierten
Patienten - HIV-Infektion - Immunrekonstitutionssyndrom
Key words
fever of unexplained origin - nosocomial infection - infections in the immunocompromised
host - HIV-infection - immune reconstitution inflammatory syndrome
