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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We agree with Mourad et al¹ that, to date, no evidence-based recommendations for the diagnostic workup of fever of unknown origin (FUO) exist, but this is also the case for their proposed approach.¹ The spectrum of diseases and the test characteristics are indeed the only available evidence, yet both are flawed. This spectrum is based on data gathered in the 1950s through the 1980s, and this represents a doubtful basis in the present era of ultrasonography, computed tomography (CT), and magnetic resonance imaging.² The proportion of abdominal abscesses and tumors has decreased in recent series because of the easy detection even by simple ultrasonography, a technique seemingly forgotten by Mourad et al¹ in their minimal diagnostic workup and algorithm.

Classic test characteristics are difficult to apply in FUO studies. There is no diagnostic gold standard against which diagnostic tests may be measured, and determining the denominator for calculation of sensitivity . . . [Full Text of this Article]

Daniel C. Knockaert, MD, PhD; Steven Vanderschueren, MD, PhD; Daniel Blockmans, MD, PhD
Leuven, Belgium

RELATED ARTICLE

An Evidence-Based Approach to Fever of Unknown Origin—Reply
Ophyr Mourad, Valerie Palda, and Allan S. Detsky
Arch Intern Med. 2003;163(16):1977-1978.
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