Megaloblastic anemia: A common but often neglected cause of pyrexia of unknown origin

OBJECTIVE: The objective was to study megaloblastic anemia as a cause of pyrexia of unknown origin (PUO). MATERIALS AND METHODS: We conducted a study on 15 patients of megaloblastic anemia associated with fever, attending our hospital clinics over a period of 6 months. RESULTS: While 11 patients had symptoms suggesting foci of infection and responded well to intravenous antibiotics, 4 patients had neither any evidence of infection nor responded with empirical broad spectrum antibiotic treatment. They were treated with vitamin B12/folate therapy which led to marked improvement in fever within 48 h. Presenting complaints of the patients and severity/duration of fever along with other epidemiological data were also studied in each case. CONCLUSION: The present study led us to conclude that megaloblastic anemia forms an important and reversible cause of fever and should be ruled out in all patients presenting with PUO. This knowledge would help the physicians in adequate and timely management of these patients.