To the question of the differential diagnosis of fever of unknown origin in children: a special case

Abstract

Fever is the most common complaint when examining pediatric patients, most often due to viral or bacterial infections. However, in some clinical situations, determining the cause of a fever is significantly difficult and may require a very wide range of differential diagnostics, which includes numerous laboratory tests and various specific methods of visualizing various structures of the child's body. In rare cases, persistent fever remains a fever of unknown origin for a long time. Fever of unknown origin is understood as a pathological condition, the main manifestation of which is fever above 38.3°C with multiple rises in body temperature for 3 weeks or more, the etiology of which has not been established, despite a set of diagnostic studies. Fever of unknown origin is one of the most difficult clinical situations for health care workers, since there is not a single diagnostic gold standard, it still remains a challenge for every doctor and requires a thorough approach to each specific case. The main directions of the diagnostic search in a child with a prolonged rise in body temperature are the exclusion of three groups of diseases: autoimmune, oncological and infectious. A clinical case with the debut of the disease from fever of unknown origin in a child is presented, a feature of this case is the absence for a long time of a sufficient number of clinical diagnostic criteria for inflammatory bowel diseases, and the sequential process of differential diagnosis is considered.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee (LEC) of all participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest were declared by the authors.