Possible Algorithm for Workup of Fever of Unknown Origin (FUO) Tier 1 Workup: • CBC, comprehensive metabolic panel • Blood & urine cultures • UA • Chest X-ray • Abdominal imaging Tier 2 Workup: • Repeat blood cultures • HIV, interferon-y release assay (e.g. QuantiFERON) • LDH, SPEP, ANA, anti-CCP Ab, ferritin, heterophile antibodies • +/- ESR, +/- CRP • CT chest • Consider: CK, ANCA, cryoglobulin, serum ACE • Consider serologies for Coxiella burnetii (Qfever), Bartonella spp and Brucella spp • Additional tests for infection depending upon geography/travel Tier 3 Workup: • ? Biopsy - Temporal artery (in elderly pts), Bone marrow, Lymph node, Liver • PET scan • Tagged WBC scan • Lumbar puncture • Neuroimaging • Echocardiogram - Dr. Eric Strong @DrEricStrong #FUO #Algorithm #Fever #Unknown #Origin #Workup #diagnosis
