English

Abstract

Acute undifferentiated fever (AUF) is common in tropical regions of the developing world, its specific etiology is often unknown. It's common causes include malaria, dengue fever, enteric fever, leptospirosis, rickettsial infection. AUF is defined as fever without any localised source of infection, of 14 days or less in duration. The objective of the study was to focus on identifying the causes of AUF in patients admitted to Intensive care units & to determine importance of clinical examination in identifying the cause. It was a prospective study done in our Medical college Hospital at Kolar, Karnataka between 1-11-2010 to 30-11-2011. Cases presenting to hospital aged >18 years with complaints of Fever & admitted in Intensive care units were included in study. A total of 558 cases were enrolled. The clinical findings were noted and subsequent Investigations required were asked for. The study compromised of approximately equal number of Male & Female patients & age varied from 18 - 100 years. There was a clear seasonal variation - More no of cases were admitted between April & November. Majority presented with Fever of Short duration (1-3 days). Certain well defined syndromes were identified like:  Fever with Thrombocytopenia - the most common of all the syndromes.  Fever with Myalgia & Arthralgia,  Fever with Hepatorenal dysfunction,  Fever with Encephalopathy,  Fever with Pulmonary - Renal dysfunction and  Fever with Multiorgan dysfunction (MODS). Out of 558 cases AUF was noted in 339 cases (60.86%). An etiological diagnosis could be made for 218 cases (39.06%). Leptospirosis was the commonest cause with 72 cases (12.9%). The no of cases with Dengue were 48(8.6%), Malaria -25 (4.4%), Viral fever -35 (6.2%), Mixed infections - 12 (2.1%), Pulmonary Tuberculosis -25 ( 4.4%) and one case of Rickettsial Infection. MODS was the most common presentation in AUF patients, seen in 108 cases (31.8%) and 40 cases expired. A study of AUF done at Siriraj Hospital, Bangkok revealed that etiologies of AUF could be determined in 38.7% of study population. It has close relevance to present study where etiologies were determined in 39.06% cases. Mortality rates observed were similar.