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Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma

Fever has preoccupied physicians since the earliest days of clinical medicine. It has been the subject of scrutiny in recent decades. Historical convention has mostly determined that 37.0°C (98.6°F) should be regarded as normal body temperature, and more modern evidence suggests that fever is a comp...

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Detalles Bibliográficos
Autores principales: Wright, William F, Auwaerter, Paul G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237822/
https://www.ncbi.nlm.nih.gov/pubmed/32462043
http://dx.doi.org/10.1093/ofid/ofaa132
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author Wright, William F
Auwaerter, Paul G
author_facet Wright, William F
Auwaerter, Paul G
author_sort Wright, William F
collection PubMed
description Fever has preoccupied physicians since the earliest days of clinical medicine. It has been the subject of scrutiny in recent decades. Historical convention has mostly determined that 37.0°C (98.6°F) should be regarded as normal body temperature, and more modern evidence suggests that fever is a complex physiological response involving the innate immune system and should not be characterized merely as a temperature above this threshold. Fever of unknown origin (FUO) was first defined in 1961 by Petersdorf and Beeson and continues to be a clinical challenge for physicians. Although clinicians may have some understanding of the history of clinical thermometry, how average body temperatures were established, thermoregulation, and pathophysiology of fever, new concepts are emerging. While FUO subgroups and etiologic classifications have remained unchanged since 1991 revisions, the spectrum of diseases, clinical approach to diagnosis, and management are changing. This review considers how newer data should influence both definitions and lingering dogmatic principles. Despite recent advances and newer imaging techniques such as 18-fluorodeoxyglucose–positron emission tomography, clinical judgment remains an essential component of care.
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spelling pubmed-72378222020-05-26 Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma Wright, William F Auwaerter, Paul G Open Forum Infect Dis Review Article Fever has preoccupied physicians since the earliest days of clinical medicine. It has been the subject of scrutiny in recent decades. Historical convention has mostly determined that 37.0°C (98.6°F) should be regarded as normal body temperature, and more modern evidence suggests that fever is a complex physiological response involving the innate immune system and should not be characterized merely as a temperature above this threshold. Fever of unknown origin (FUO) was first defined in 1961 by Petersdorf and Beeson and continues to be a clinical challenge for physicians. Although clinicians may have some understanding of the history of clinical thermometry, how average body temperatures were established, thermoregulation, and pathophysiology of fever, new concepts are emerging. While FUO subgroups and etiologic classifications have remained unchanged since 1991 revisions, the spectrum of diseases, clinical approach to diagnosis, and management are changing. This review considers how newer data should influence both definitions and lingering dogmatic principles. Despite recent advances and newer imaging techniques such as 18-fluorodeoxyglucose–positron emission tomography, clinical judgment remains an essential component of care. Oxford University Press 2020-05-02 /pmc/articles/PMC7237822/ /pubmed/32462043 http://dx.doi.org/10.1093/ofid/ofaa132 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Review Article
Wright, William F
Auwaerter, Paul G
Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma
title Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma
title_full Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma
title_fullStr Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma
title_full_unstemmed Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma
title_short Fever and Fever of Unknown Origin: Review, Recent Advances, and Lingering Dogma
title_sort fever and fever of unknown origin: review, recent advances, and lingering dogma
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7237822/
https://www.ncbi.nlm.nih.gov/pubmed/32462043
http://dx.doi.org/10.1093/ofid/ofaa132
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