Fever Infection Research Articles

Etiology and clinical characteristics of pediatric acute fever among hospitalized children in an endemic malaria transmission area of Cameroon in Central Africa.

Acute fever in the majority of children in resource-limited countries is attributable to malaria and often treated without laboratory evidence. The aim of the study was to characterize acute pediatric infectious fevers (APIF) in the pediatric department of the Douala Laquintinie Hospital. A cross-sectional study was conducted among children aged 2 months to 15 years who were admitted with an acute fever (anal temperature ≥ 37.5°C less than 5 days in infants and 7 days in adolescents). 200 children were included and followed up during their hospitalization. The mean age was 3.7 (IQ25-75: 1-4.6) years. More than 3 out of 5 patients (62.5%) came from another health facility and anemia accounted for 29% of the reasons for consultation associated with fever. The main symptoms were vomiting (28%), cough (26%), convulsions (21%) and diarrhea (20%). Skin-mucosal pallor (43.0%) and hepatosplenomegaly (26.0%) were the most common physical signs encountered. Among febrile children, 116/200 (58%) were infected with at least 1 pathogen, and 1/200 (0.5%) had a fever of unknown etiology. Malaria (53% vs 80.5% presumptive) associated with anemia (95.3% of cases) was the most common pathology associated with APIF, followed by pneumonia (19.5%), meningitis (11.5%) and urinary tract infections (10% vs 54.5% presumptive). Malaria was over-diagnosed on admission and over-treated as well as urinary tract infection. A better understanding of common pathogens carriage, a better capacity for improved diagnosis and a better applied clinical algorithm for febrile illnesses in children are needed.

Prevalence and risk factors associated with Q fever infection in slaughterhouse workers in Fars province, Iran.

Q fever is a main occupational zoonotic disease. Slaughterhouse is one of the most remarkable ways of transmitting the infection from livestock to humans. This study aimed to survey the prevalence of Q fever in slaughterhouse workers in Fars province, Iran, for the first time. Ninety serum samples were collected from slaughterhouse workers and tested to detect Immunoglobulin G (IgG) against Coxiella burnetii using ELISA and indirect immunofluorescence assay (IFA). PCR was also applied to identify C. burnetii DNA in the blood samples. Q fever seroprevalence was found at 26.7% in ELISA, showing recent infection. This result indicates that Q fever seroprevalence is relatively high in the Fars region. IFA showed a high seroprevalence of total IgG antibodies at 1:64 titer (73.3%) and relatively high IgG at 1:256 titer (40%) against C. burnetii. 2.2% of the workers were recognized as having probable acute Q fever. The IgG II prevalence at 1:64 and 1:256 titers was, respectively, 63.3% and 24.4% positive. The IgG I prevalence at 1:64 and 1:256 titers was also found 33.3% and 22.2% positive, respectively. Molecular prevalence of Q fever was also 8.9%. A significant relationship was found between IgG I seropositivity and longer work experience and employing other livestock-related jobs (animal husbandry and butchery) (P < 0.05). As such, the high seroprevalence of Q fever among abattoir workers highlights the importance of further comprehensive epidemiological studies, occupational screening programs, and preventive measures for Q fever in high-risk groups. This also warns animal health care organizations about the risk of Q fever infection in livestock in this region.

Prevalence of Crimean-Congo haemorrhagic fever in livestock following a confirmed human case in Lyantonde district, Uganda

BackgroundCrimean-Congo haemorrhagic fever (CCHF) is a tick-borne viral infection, characterized by haemorrhagic fever in humans and transient asymptomatic infection in animals. It is an emerging human health threat causing sporadic outbreaks in Uganda. We conducted a detailed outbreak investigation in the animal population following the death from CCHF of a 42-year-old male cattle trader in Lyantonde district, Uganda. This was to ascertain the extent of CCHF virus (CCHFV) circulation among cattle and goats and to identify affected farms and ongoing increased environmental risk for future human infections.MethodsWe collected blood and tick samples from 117 cattle and 93 goats, and tested these for anti-CCHFV antibodies and antigen using an enzyme-linked immunosorbent assay (ELISA), quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and target enrichment next generation sequencing.ResultsCCHFV-specific IgG antibodies were detected in 110/117 (94.0%) cattle and 83/93 (89.3%) goats. Animal seropositivity was independently associated with female animals (AOR = 9.42, P = 0.002), and animals reared under a pastoral animal production system (AOR = 6.02, P = 0.019] were more likely to be seropositive than tethered or communally grazed animals. CCHFV was detected by sequencing in Rhipicephalus appendiculatus ticks but not in domestic animals.ConclusionThis investigation demonstrated very high seroprevalence of CCHFV antibodies in both cattle and goats in farms associated with a human case of CCHF in Lyantonde. Therefore, building surveillance programs for CCHF around farms in this area and the Ugandan cattle corridor is indicated, in order to identify opportunities for case prevention and control.Graphical

MEK/ERK activation plays a decisive role in Zika virus morphogenesis and release.

Brazil has experienced an increase in outbreaks caused by flaviviruses. The high incidence of dengue fever, the morbidity of Zika in children, and the high mortality of yellow fever have affected millions in recent years. Deciphering host-virus interactions is important for treating viral infections, and the mitogen-activated protein kinases (MAPK) are an interesting target because of their role in flavivirus replication. In particular, mitogen-activated protein kinase kinase (MEK), which targets extracellular-signal-regulated kinase (ERK), is necessary for dengue and yellow fever infections. In this study, we evaluated the role of the MEK/ERK pathway and the effect of the MEK inhibitor trametinib on the Asian ZIKV strain PE243 and the prototype African ZIKV strain MR766, addressing genome replication, morphogenesis, and viral release. ZIKV infection stimulated ERK phosphorylation in Vero cells at 12 and 18hours postinfection (hpi). Trametinib showed sustained antiviral activity, inhibiting both ZIKV strains for at least four days, and electron microscopy showed probable inhibition of ZIKV morphogenesis. ZIKV PE243 can complete one cycle in Vero cells in 14hours; genome replication was detected around 8hpi, intracellular viral particles at 12hpi, and extracellular progeny at 14hpi. Treatments at 6-hour intervals showed that trametinib inhibited late stages of viral replication, and the titration of intra- or extracellular virions showed that the treatment especially affected viral morphogenesis and release. Thus, ZIKV stimulated ERK phosphorylation during viral morphogenesis and release, which correlated with trametinib inhibiting both the signaling pathway and viral replication.

Educating Parents about Fever in Childhood Evaluation of the Effect of an Information Leaflet

Fever is an important immune reaction of the body in infections and plays a major role in childhood. Fear and uncertainty in dealing with fever are still widespread among parents. Information leaflets on the knowledge and handling of fever in childhood can serve as an educational tool for parents. It has not yet been investigated whether this type of information transfer is a suitable tool for educating parents. 16 kindergartens in Saarland were visited. 481 parents of at least one child between the ages of 1 and 7 years answered a questionnaire on knowledge, approach and handling of fever in infections. Subsequently, an information leaflet on fever was handed out. On the following day, the questionnaire was answered again by the 190 parents who had read the information leaflet. The change due to reading the information leaflet was analyzed. 40% of the participants read the information leaflet. 87% mothers and 13% fathers participated in the follow-up survey. 10% of the post-survey respondents had a secondary school diploma and 34% had a university degree. After reading, fever was considered useful significantly more often and febrile convulsions and consequential damage were mentioned significantly less often as a reason for fever reduction. Information leaflets on fever can be a complementary tool for education, the short-term effect is confirmed, the sustainability needs to be further evaluated. There is also a need to reach the majority.

Concurrent Infection of Dengue and Malaria: An Unusual Case Report

Plasmodium knowlesi is one of the most common causes of Malaria in humans. Although several reported cases of dengue and Malaria occur together, only a few cases have been reported in Southeast Asia, including Indonesia. This study aims to provide additional insight into the epidemiology and clinical aspects of Plasmodium knowlesi (P. knowlesi) malaria infection and dengue fever that occur concurrently in Southeast Asia, particularly Indonesia. A 36-year-old male patient with a history of travel to the mountainous area of Lhoknga and a fever for five days sought treatment at the emergency department of Meuraxa Hospital. During 11 days of treatment, the patient underwent a routine haematology examination every 24 hours. The average platelet count during the first eight days was around 50,000, with an increase after anti-malarial treatment on the eighth day and marked clinical improvement. The patient was discharged on day 10 with no signs of bleeding or hemolysis during treatment. Diagnosis involved blood smears and hematologic examination, confirming dengue fever with P. knowlesi malaria infection. These findings emphasize the importance of thorough history taking, physical examination, and supporting investigations to diagnose these two conditions together. The results of this study may provide critical support for case management involving malaria infection and dengue fever, with a focus on platelet monitoring as an indicator of response to treatment in the Southeast Asian region.

Influence of Post-Harvest Drying Processes on the Composition and Biological Activities of Essential Oils from Leaves of Camphor Tree from Uttarakhand Himalaya, India

Cinnamomum camphora L. belonging to family Lauraceae, is an aromatic evergreen plant which has been traditionally used to heal several health problems such as cold, fever, pneumonia, diarrhea and various infections. In this study, four drying treatments (sun, shade, blower and oven) were applied on the leaves of C. camphora collected in summer season and their effect on the yield, composition and biological properties of the essential oil was evaluated. Hydro distillation of fresh and dried samples was carried out by Clevenger apparatus and essential oils obtained were analyzed by GC and GC/MS. Alpha-pinene, camphene, myrcene, limonene and camphor were the common major constituents of the essential oils. The highest essential oil yield was obtained by blower drying technique. Shade dried sample possessed the best antioxidant, antiinflammatory and α-amylase inhibition activities. The highest percentage of camphor was obtained in sun dried plant material. Despite of comparatively low essential oil yield in sun dried C. camphora, sun drying technique is less energy consuming and increased the content of major component of camphora leaves.

Gender Distribution and Reasons for Donor Deferral in Blood Donors at a Tertiary Healthcare Centre, Kerala, India: A Cross-sectional Study

Introduction: One of the primary responsibilities of the blood bank is to provide safe blood to patients. Blood donors are screened before blood donation and deferred from donating if they have diseases or conditions that may affect blood quality or lead to adverse reactions. Blood donor deferral ensures both donor and patient safety. Understanding deferral reasons can help raise awareness among blood donors. Aim: To determine the percentage of female blood donors and the number of deferrals in male and female donors for various reasons. Materials and Methods: This retrospective cross-sectional study was conducted at Department of Transfusion Medicine, Government Medical college, Kozhikode, Kerala, India. The study period was one year from April 2018 to March 2019. Data on the number of male and female donors, donors accepted for donation, and those deferred for various reasons were collected through questionnaires and blood bank records. Data analysis was performed using Stastistical Packages of Social Sciences (SPSS) version 17.0 software, employing the Chi-square test with a significance level of p&lt;0.05. Results: Out of 36,318 blood donors, only 1,521 (4.2%) were females. During the study period, 30,007 donors were selected for donation, of which 792 (2.64%) were female donors. Among the 6,311 deferred donors, 1,171 (18.55%) were deferred due to fever and respiratory tract infections, the most common reason for deferral. The deferral rate for females was significantly higher than for males. Females had a deferral rate of 47.9% (729 out of 1,521 female donors), while males had a deferral rate of 16.04% (5,582 donors). Fever and respiratory tract infections were the main cause of deferral among males, with 1,055 (18.9%) deferred for this reason. Among females, low haemoglobin (306, 41.98%) was the primary cause of deferral. Conclusion: Females constitute a minority of the blood donor population. Motivational efforts can increase blood donation among females. Raising awareness about nutritional anaemia and implementing preventive measures can reduce deferrals among female blood donors.

First case report of Pseudomonas Luteola isolated from urinary tract infection in Babylon City, Iraq

Urinary tract infections (UTIs) are common in both men and women. They are caused by bacteria that get into the urinary tract through the urethra (the tube going from the penis to the bladder) or, in rare cases, the ureters (tubes that carry urine from the kidneys to the bladder). Risk factors for developing a UTI include having a catheter inserted to drain the bladder or a surgical wound on the urinary system. Pseudomonas luteola (P.luteola) is a Gram-negative, rod-shaped bacterium considered ecologically problematic and can cause pneumonia and urinary tract infections in humans. It is a common cause of hospital-acquired pneumonia and accounts for around 20% of all such cases. P. luteola causes fever, tachycardia, and other signs of infection, but some of these symptoms may be present for many weeks before the symptoms ofinfection are clear. According to our knowledge, this is the first detection in January 2023, of P. luteola in Iraq, Babylon City from a 51-year-old woman with chronic urinary tract infections and kidney failure (dialysis).

Global dynamics of deterministic-stochastic dengue infection model including multi specific receptors via crossover effects

&lt;abstract&gt;&lt;p&gt;Dengue viruses have distinct viral regularities due to the their serotypes. Dengue can be aggravated from a simple fever in an acute infection to a presumably fatal secondary pathogen. This article investigates a deterministic-stochastic secondary dengue viral infection (SDVI) model including logistic growth and a nonlinear incidence rate through the use of piecewise fractional differential equations. This framework accounts for the fact that the dengue virus can penetrate various kinds of specific receptors. Because of the supplementary infection, the system comprises both heterologous and homologous antibody. For the deterministic case, we determine the invariant region and threshold for the aforesaid model. Besides that, we demonstrate that the suggested stochastic SDVI model yields a global and non-negative solution. Taking into consideration effective Lyapunov candidates, the sufficient requirements for the presence of an ergodic stationary distribution of the solution to the stochastic SDVI model are generated. This report basically utilizes a novel idea of piecewise differentiation and integration. This method aids in the acquisition of mechanisms, including crossover impacts. Graphical illustrations of piecewise modeling techniques for chaos challenges are demonstrated. A piecewise numerical scheme is addressed. For various cases, numerical simulations are presented.&lt;/p&gt;&lt;/abstract&gt;

A study on risk factors and outcome in prelabour rupture of membrane

Background and Objectives: During the last three decades it has taken a new dimension because of identification of clinical risk factors and improved fetomaternal outcome due to better management. The present study aimed to assess the maternal and fetal outcome in patients with prelabour rupture of membrane. Methods: The present prospective cross-sectional study was conducted among the patients presenting with spontaneous rupture of membrane, admitted in Department of OBG of Al-Ameen Medical College Medical College, Athani road, Vijayapura. Informed consent was taken from all enrolled patients after detailed counselling. The contents of the consent were read out to the patients in his language. Detailed history taking including age, parity, weight gain, inter pregnancy interval. History emphasized on exact time of rupture of membrane and duration the amount of leak. Detailed examination like blood pressure, height, temperature was noted. In obstetric history uterine height, fetal presentation, fetal heart rate, estimated weight and other parameters of maternal and fetalwell-being was noted. A sterile speculum examination was conducted and presence of liquor amini was noted. The maternal and fetal outcome were monitored and recorded in the Performa. All the data were entered in excel sheet and the analysis was performed using SPSS V.21.0 operating on windows 10. Results: Present study total of 100 patients fulfilling inclusion criteria are included in present study after obtaining the informed consent. The mean age of the patients was found to be 24.92. The maternal complications seen among patients were with 34% puerperal fever, followed with 10% with wound infections and 3% with UTI. Among the fetal complications, the study documented majority with presence of respiratory distress syndrome in 17% of the newborn, followed with 4% meconium aspiration, 3% with conjunctivitis and 1% with sepsis and still birth. Conclusion: The present study documented the major etiological factors for PROM among study participants was following the coitus, followed with history of previous pregnancy leaking. The study also documented the common mode of delivery was lower segment caesarean section with cause of failure to progress among them. The maternal complication documented was majority with puerperal fever and wound infection. The newborn complication documented was majority with respiratory distress syndrome followed with meconium aspiration.

Identification of potential CD8+ epitopes in pp62 polyprotein of African swine fever virus using computational immunology.

The highly infectious African swine fever virus (ASFV) is currently the only known DNA arbovirus within the Asfarviridae family which primarily infects domestic pigs and wild boars. African swine fever (ASF) leads to a mortality rate of up to 100% which has caused massive socio-economic losses worldwide. Previous research indicates that ASFV's virulence can be attributed to polyprotein pp62, which plays a crucial role in viral assembly and core maturation. This particular study utilized in silico analysis to identify highly conserved cytotoxic T-cell epitopes in pp62 that can potentially serve as key components for future ASFV vaccines. To achieve this, the researchers retrieved, clustered, and aligned the peptide sequences of pp62. Subsequently, the aligned sequences were analyzed to identify epitopes that bind promiscuously to the swine major histocompatibility complex I (MHC I) alleles and exhibiting MHC IC50 values < 500 nM. Additionally, peptide sequences with positive proteasome and TAP scores were considered. Potential cross-reactivity was assessed by comparing the peptide sequences against available proteome sequences of Sus scrofa domesticus in various databases. Furthermore, molecular docking was conducted to evaluate the binding of candidate epitopes with swine leukocyte antigen-1*0401 (SLA-1*0401). The dissociation constants, binding energies, root mean square deviation, and root mean square fluctuation values for the SLA-epitope complexes were compared with a positive reference. In the course of the study, 21 highly conserved CD8+ epitopes were identified, out of which four were further assessed for their potential immunogenicity. The results demonstrated that the highly conserved CD8+ epitopes discovered in this study are promising for integration into future ASFV vaccine formulations. As preliminary data, it is anticipated that these findings will subsequently undergo in vitro and in vivo studies in the future.

Дифференциальный диагноз колитов при COVID-19 и бактериальных кишечных инфекциях у детей

Diarrhea with COVID-19 develops in 2–79% of patients. The causes and clinical features of gastrointestinal lesions in patients are different, and the differential diagnosis with acute intestinal infections is difficult. The purpose is to provide a comparative clinical and laboratory characteristics of distal colitis in COVID-19 and classical bacterial diarrhea (salmonellosis, campylobacteriosis). Material and methods. As part of the case-control study, two groups of patients were formed: main group (continuous sample) — 48 children with COVID-19 and negative results of a standard examination for acute respiratory infections pathogens; and control group — 48 children with bacterial colitis. Statistica 8 (USA) and StatTech v 3.1.8. software were used for statistical data analysis. Additionally, multivariate logistic regression and ROC curve analyses were performed. Result and conclusions. Among all children hospitalized with COVID-19 in 2022, 26.2% (48/183) had evidence of distal colon involvement. The most important factors for the differential diagnosis were: the frequency of stool and vomiting, the signs of hemocolitis and dehydration, a concomitant pathology, and the number of red blood cells in the general clinical blood test. The prognostic model developed based on these features has a sensitivity of 93.8% and a specificity of 93.6%. In addition, patients with COVID-19 with a clinical picture of distal colitis were distinguished from bacterial infections by febrile (not pyretic, as in bacterial acute intestinal infections) fever, lymphopenia, and a shorter duration of hospitalization.

Tapeworm infection and secondary hemorrhagic shock found after cervical cancer surgery: a case report

Radical hysterectomy is an essential component of surgery for early-stage cervical cancer, and secondary hemorrhagic shock due to infection and vaginal stump necrosis after laparoscopic hysterectomy is very rare. Here we report a tapeworm infection and secondary hemorrhagic shock in a patient with cervical cancer after radical hysterectomy. On day two after cervical cancer surgery, this patient was found to have a long-term intestinal tapeworm infection and was discharged on postoperative day 11 after deworming on postoperative day 4. The patient entered the emergency operating room for hemorrhagic shock on day 15 after cervical cancer surgery; after hemodynamic resuscitation, gauze tamponade, and anti-infective treatment, the patient’s massive blood loss temporarily stopped. Two days later, the patient’s vaginal stump bled again repeatedly. Eventually, after 17 hours of surgery and hemodynamic resuscitation, the patient’s wound stopped bleeding profusely with ligation of the right internal iliac artery and branch arteries. This patient had a rare tapeworm infection that presented preoperatively but was detected only after cervical cancer surgery. We considered that preoperative anemia, long surgery time, surgical trauma, and intraoperative blood loss have significantly suppressed the patient’s immune response. A long-term intestinal tapeworm infection increased her susceptibility to bacteria, resulting in secondary pathogenic infection and postoperative blood loss. We advised that if a patient has combined parasitic infection and recurrent fever after a hysterectomy, it is necessary to prolong the hospital stay time, improve anemia, and increase immunity until the condition stabilizes before discharge.

Pathological Events of Lassa Fever Infection

Pathological Events of Lassa Fever Infection

Intrapancreatic accessory spleens in African swine fever infection of wild boar (Sus scrofa).

Intrapancreatic accessory spleen (IPAS) is one of the most frequent congenital splenic anomalies in humans; however, studies in veterinary medicine are scarce. This study aimed to describe the macroscopic, histopathological and immunohistochemical features of 11 suspected cases of IPAS in wild boar piglets of 3-4 months old. Seven of the 11 animals were immunised with a low virulence isolate of African swine fever virus (ASFV) and subsequently challenged with a highly virulent ASFV isolate (LVI-HVI group). The remaining four animals were exclusively infected with a highly virulent isolate of ASFV (HVI group). Grossly, lesions comprised focal or multifocal reddish areas of variable shape, located on the surface of the pancreatic tail or within the parenchyma. Histological and immunohistochemical studies (anti-CD79 and CD3) confirmed the presence of IPAS in eight of the 11 cases. IPAS shared the same histological structure and alterations as those observed in the original spleen. The immunohistochemical study against ASFV revealed the presence of VP72+ cells in both the spleen and IPAS of seven of the eight piglets. The results of this study describe for the first time the presence of IPAS in ASFV infection of wild boar (Sus scrofa) regardless the isolate and suggest that the infection may induce the development of ectopic splenic tissue due to an increased demand for phagocytic cells from the reticuloendothelial system. However, further studies are needed to understand the immunological mechanisms that trigger the formation of these accessory organs.

Scourge of Lassa fever pandemic in Nigeria: The roles of library and information professionals in mitigating the spread of the disease

The paper explored the Lassa fever pandemic which is currently the most deadly disease ravaging most part of Nigeria. While it is disturbing that adequate environmental cautions were not been taken to inhibit its seasonal outbreak, it is more worried that 54 years after discovery of Lassa fever disease in Nigeria, stakeholders have failed to produce vaccines against the disease making it the worst in the history of the country. The disease has also spread rapidly in some part of West African countries. Literatures revealed that in the first quarter of 2023, Lassa fever have killed 203 persons across the 26 states in Nigeria. Also, 869 Lassa fever cases were confirmed between March and April, 2023 with predominant age 21-30 years mostly affected. Lassa fever has also 16.7% fatality rates which indicated a serious health challenges across the country. Lassa fever infections became a scourge in Edo, (115 cases), with 113 deaths, Ondo (90 cases), with 48 deaths and Bauchi, (71 cases), with 24 deaths. This necessitated the reason for the paper in creating platform for public enlightenment and education. The role of library and information professionals in raising awareness through public health education, information literacy in Nigeria became a key to mitigate the spread of the disease. The paper advocated strategies with the provision Internet services and social media as a means of providing useful sources of information that would help the general public to be aware on the danger of Lassa fever pandemic. The paper emphasized that proper information awareness through advocacy programmes to mitigate increase in Lassa fever cases by library and information professionals have become a gateway to stop the spread of the disease. The paper concluded that library services were impediment for improving health awareness of the users through education, information and public enlightenment. It is recommended that library and information professionals should serve as a catalyst in the promotion of public health through information awareness and dissemination.

Retracted: Comparison between Ibuprofen and Acetaminophen in the Treatment of Infectious Fever in Children: A Meta-Analysis.

[This retracts the article DOI: 10.1155/2022/1794258.].

Analysis of the application value of functional status-based personalized nursing in clinical care for acute leukemia

To discuss the functional status-based personalized nursing in clinical care for acute leukemia. 175 patients with acute leukemia were divided into the conventional care group (patients within the group received routine care during chemotherapy for acute leukemia) and the observation group (patients within the group received functional status-based personalized care on the foundation of routine care) according to the method of random number table, and the mental status, quality of life, physical function status and complications during chemotherapy were compared between groups. Compared to the conventional care group following the intervention, the scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were notably decreased in the observation group following the intervention. The scores of quality of life (QOL) and Karl Fischer Physical Functional Status Scale (KPS) were conspicuously increased, and the differences indicate statistical significance (p &lt; 0.05); Compared with the conventional care group, the incidence of infection infectious fever, bleeding and ectopic liver function during chemotherapy in the study group were evidently reduced. The differences are statistically significant (p &lt; 0.05). The functional status-based personalized nursing can effectively improve the mental status and quality of life, promote the physical function status, and effectively decrease the complications during chemotherapy in patients with acute leukemia, which is a safe and effective nursing model.

Dilemmas in Diagnosis of Urinary Tract Infection (UTI) in Fever without Focus and other conditions

Dilemmas in Diagnosis of Urinary Tract Infection (UTI) in Fever without Focus and other conditions