Comparison of classical diagnostic criteria and Chinese revised diagnostic criteria for fever of unknown origin in Chinese patients

Jia-Jun Li, Wen-Xiang Huang, Zheng-Yu Shi, Qiu Sun, Xiao-Juan Xin, Jin-Qiu Zhao, Zhen Yin Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China Background: Fever of unknown origin (FUO) has always been a challenging problem for physicians since it was first reported half a century ago. This study aimed to investigate the clinical features of FUO and to compare the clinical significance of the classical diagnostic criteria and the Chinese revised diagnostic criteria of FUO. Methods: We retrospectively collected a series of 140 patients admitted to our hospital between September 2011 and June 2013 because of prolonged febrile illnesses (lasting at least 2 weeks, temperature ≥38.5°C) without diagnosis and categorized them into two groups according to the Chinese revised diagnostic criteria (group A) and classical diagnostic criteria (group B) for FUO. The A group included patients presenting with fever persisting between 2 and 3 weeks with the diagnosis remaining uncertain after three outpatient visits or at least 3 days of hospital investigation. The B group included patients presenting with fever persisting for more than 3 weeks with no established diagnosis after 1 week of hospital investigation. The general conditions, etiologies, definite diagnosis times, and diagnostic methods of the two groups were compared. Results: There were no significant differences in the general conditions, etiologies, definite diagnosis times, and diagnostic methods between the Chinese revised diagnostic criteria and classical diagnostic criteria. Conclusion: Both the examined FUO diagnostic criteria are suitable for clinical practice in this region. Keywords: fever of unknown origin, diagnostic criteria, comparison, drug design