Workup-fever of unknown origin

search for potentially diagnostic clues (PDCs)

• Initial: CBC w/ diff, CMP, ESR, CRP, 3 sets BCx (off abx), U/A, UCx, CXR
• Additional workup based on sx: ANA, RF, cryoglobulin, LDH, CK/aldolase, SPEP, TFTs, PPD or IGRA, HIV Ag/Ab ± PCR, RPR, EBV serologies, CMV PCR, HBV/HCV serologies
• Consider imaging: chest & abd CT, tagged WBC scan, FDG-PET, TTE, LE duplex US
• Tissue dx: consider bx of LN (excisional preferred), liver (especially if ↑ Aϕ), TA (for GCA), BM, kidney (RPGN)
• 伴有頭痛的 FUO 應提示對腦脊液 (CSF) 進行微生物學檢查，
  • 尋找包括單純疱疹病毒（尤其是 2 型）、新型隱球菌和結核分枝桿菌在內的微生物。
  • 在中樞神經系統結核病中，CSF 通常具有升高的蛋白質和降低的葡萄糖濃度，伴有單核細胞增多。

---