Ruiz-Contreras J, De Jose MI, Ciria L, Mellado MJ, Ramos JT, Clemente J, Rodriguez-Cerrato V; International Conference on AIDS.
Int Conf AIDS. 1998; 12: 44 (abstract no. 12165).
Hospital 12 de Octubre Dpto Pediatria, Spain.
BACKGROUND: There are few reports of fever of unknown origin (FUO) in HIV-infected children. The aims of this study are: 1) to describe the number and characteristics of episodes of FUO in HIV-infected children less than 13 years of age; 2) to assess diagnostic methods that were carried out; 3) to know the survival time since the episode of FUO was diagnosed. METHODS: Retrospective review of the charts of HIV-infected children in four tertiary university hospitals in Spain. FUO was defined as fever for 7 or more days in children whose initial history, physical examination and laboratory data (including bacterial cultures) failed to reveal the cause. RESULTS: Overall 316 charts of HIV-infected children were recovered and 67 episodes of FUO were identified in 53 (17%) children. Most of these episodes (83%) occurred in patients with HIV advanced disease (C3, 43 cases; B3, 8 case.s) and 79% had a previous history of opportunistic infections (mostly oral and/or esophageal candidiasis). In 75% and 73% of episodes of FUO, the patients were receiving cotrimoxazol prophylaxis and antirRetroviral treatment respectively. The diagnoses were: FUO, 24 cases (36%); disseminated MAC infection, 11 cases (16%); tuberculosis, 11 patients (extrapulmonary disease in 3 of them); B lymphoma, 4 cases (6%); disseminated CMV infection, 3 cases (4%). Other less frequent diagnoses were: drug fever, endocarditis, HIV primary infection, pancreatic abscess, Pseudomonas aeruginosa bacteremia and visceral leishmaniasis. Duration of fever before the admission was 10.5 +/- 12 days (median 7) and total duration was 25 +/- 17.6 days (median 21). Invasive procedures were carried out in 23 cases (34%). Forty (75%) patients have died since the episode of FUO (survival 12 +/- 17 months). In 17 of them the death was directly related to the episode of FUO. CONCLUSIONS: Fever of unknown origin is a common entity in HIV infected children especially in those with advanced disease and consequently it presents a poor prognosis, as 75% of the children die shortly after diagnosis. In about half of the cases no cause is found; disseminated MAC infection, tuberculosis and tumours are the most frequently identified causes of FUO in Spain.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Child
- Communicable Diseases
- Fever
- HIV
- HIV Infections
- HIV Seropositivity
- Humans
- Leishmaniasis, Visceral
- Medical History Taking
- Physical Examination
- Spain
- Tuberculosis
Other ID:
UI: 102226866
From Meeting Abstracts