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An Evidence-Based Approach to Fever of Unknown Origin—Reply
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In reply
Knockaert et al have made some very insightful comments that highlight the complexity of FUO and how the paucity of good evidence has resulted in a lack of consensus. We have attempted to provide an approach and guidance for the evaluation of such patients using existing evidence.1
A thorough history review and physical examination impact pretest probabilities and may direct physicians to tests that do not conform to our proposed algorithm. Knockaert et al have identified potential diagnostic clues as one way of influencing clinical judgment and guiding testing. We agree that one must not ignore the art of medicine, but it should not be divorced from the science.
Computed tomography has emerged as the imaging modality of choice for the identification of intra-abdominal fluid collections and abscesses owing to its higher sensitivity (90%-100%)2-4 compared with ultrasound (80%-85%).2, 5 The advantage of CT over ultrasound is that ultrasound images . . . [Full Text of this Article]
Ophyr Mourad, MD;
Valerie Palda, MD, MSc;
Allan S. Detsky, MD, PhD
Toronto, Ontario
RELATED ARTICLE
An Evidence-Based Approach to Fever of Unknown Origin
Daniel C. Knockaert, Steven Vanderschueren, and Daniel Blockmans
Arch Intern Med. 2003;163(16):1976-1977.
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