Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Save to My Library
Look up keyword
Like this
2Activity
0 of .
Results for:
No results containing your search query
P. 1
Examville.com - Pyrexia of Unknown Origin [PUO] Review Notes

Examville.com - Pyrexia of Unknown Origin [PUO] Review Notes

Ratings:

5.0

(1)
|Views: 775 |Likes:
Published by Examville.com
Examville.com is a global education community where users like you can connect and interact with other students and teachers from around the world. Share, seek, download and discuss everything inside and outside the classroom.

All you need is an email address and a password to get started.

Examville features include:
Live online classes and review sessions
Study aids
Practice online standardized tests (SAT, GRE, GMAT, LSAT, MCAT, etc.)
Q&A (post questions and solutions to academic problems)
Study groups
Marketplace
Meet Up

>> Get Started at http://www.examville.com
Examville.com is a global education community where users like you can connect and interact with other students and teachers from around the world. Share, seek, download and discuss everything inside and outside the classroom.

All you need is an email address and a password to get started.

Examville features include:
Live online classes and review sessions
Study aids
Practice online standardized tests (SAT, GRE, GMAT, LSAT, MCAT, etc.)
Q&A (post questions and solutions to academic problems)
Study groups
Marketplace
Meet Up

>> Get Started at http://www.examville.com

More info:

Published by: Examville.com on Feb 02, 2009
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF or read online from Scribd
See more
See less

05/10/2014

 
 APPLIED MICROBIOLOGY
 
Pyrexia of Unknown Origin (PUO)
The normal body temperature is 37°C (98.8°F). The elevation of body temperature above the normal isconsidered as fever. When fever persists or lasts for 10 days or more without any obvious cause then itis termed as PUO or fever of unknown origin (FUO).
Types of PUO
Classical PUO - Fever (>38.3°C) on several occasions and more than three weeks durationNosocomial PUO - Fever (>38.3°C) on several occasions in hospitalised patient; infection neitherpresent nor incubating at the time of admission to hospitalNeutropenic PUO - Fever (>38.3°C) on several occasions; neutrophil count <500/ cu mm in peri-pheral bloodHIV-associated PUO - Fever on several occasions (>38.3°C). More than three weeks as outpatientor more than three days as inpatient. HIV serology positive.
 
Causes of PUOInfectiousCausesNon Infectious Causes
 
Neoplasms such as lymphoma, leukaemia, hepatomaand other forms of cancer
 
Collagen diseases such as systemic lupus rythematosus,rheumatic fever etc.
 
Metabolic disorders such as gout and porphyria
 
Anaemia
 
Drug induced fever, e.g. sulphonamide reaction
 
Central nervous system abnormalities
 
Allergic reactions such as serum sickness
 
Alcoholic patient with liver disease
 
Granulomatous diseases such as sarcoidosis, Crohn'sdisease, granulomatous hepatitis etc.
 
Vascular diseases such as arteritis, cerebrovascularaccidents, myocardial infarction, pulmonarythromboembolism
 
Trauma such as crush injury, head injury
 
Miscellaneous causes-dehydration, hypothalamiclesions, thyroiditis, etc.
 
Heat fever-during summer days body temperature inyoung children and old people may become elevatedtowards early afternoon
 
Psychogenic fever, i.e. fictitious fever
InfectiousCauses
 
 
A. Bacterial Causes
 
Mycobacterium tuberculosis
 
Salmonella
sp.
 
Brucella
sp.
 
Chlamydia psittaci
 
Leptospira
sp.
 
Borrelia
sp.
 
Rickettsia
sp.
 
Neisseria
sp.
 
Francisella tularensis
 
Mycoplasma
sp.
 
Streptococci
 
Pneumococci
 
Bacteroides
sp.
 
Listeria monocytogenes
 
Legionella pneumophila
 
Treponema pallidum
 
Coxiella burnetii
 
Atypical mycobacteria
Clinical Features
In persons with acute febrile illness (microbial infection), the symptoms are:
o
 
Chills followed by rapid rise of temperature
o
 
Flushing of tissue
o
 
Intense sweating
o
 
Malaise
o
 
Lethargy
o
 
Weakness
o
 
ShockIn persons with neoplastic disease, the symptoms are:
o
 
Emaciation
o
 
Fever
o
 
Chills
o
 
Weight loss
o
 
Headache
o
 
Photophobia
o
 
General malaiseSystemic symptoms in fever are:
o
 
Pain in back
o
 
Generalized myalgias
o
 
Arthralgia without arthritis
o
 
Sometimes delirium and convulsions
Laboratory Diagnosis in PUOB. Viral Causes
· Cytomegalovirus· Epstein-Barr virus· Hepatitis A and B viruses· Arboviruses· Enteroviruses· Adenoviruses· Myxoviruses· Human immunodeficiency virus (HIV)· Haemorrhagic fever viruses
C. Fungal Causes
· Candida albicans· Cryptococcus neoformans· Histoplasma capsulatum· Aspergillus
sp.
· Coccidioides immitis· Pneumocystis carinii
D. Parasitic Causes
· Malarial parasites
· Leishmania
sp.
· Trypanosoma
sp.(In tropical Africa)
· Toxoplasma gondii· Entamoeba histolytica
· Filarial
parasites
 
 
 A.
 
Routine Screening Tests
These include estimation of haemoglobin, total leucocyte count, differential leucocyte count, ESRand eosinophil count which may give an indication regarding the type of infection for e.g. Atypicalmononuclear cells suggests glandular fever, Eosinophilia suggests parasitic infections
B. Biochemical Investigations
 These include liver function tests such as: Aminotransferase-in viral hepatitis, Alkalinephosphatase-in brucellosis, alpha-fetoprotein in hepatoma
C. Microbiological Investigations1. Blood Culture2. Urine Examination
· Routine microscopy-pus cells· Z-N stain-to rule out tuberculosis· Routine culture-for bacterial infection · Culture on L-J for tubercle bacilli
3. Stool Examination
Stool microscopy-for detecting ova and cyst · Stool culture-to rule out GIT infections
4. Sputum Examination
· Z-N stain-to rule out tuberculosis· Routine culture and culture on L-J medium to rule out bacterial and mycobacterialcauses

Activity (2)

You've already reviewed this. Edit your review.
1 thousand reads
1 hundred reads

You're Reading a Free Preview

Download
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->