Fever of unknown origin (FUO) on a land on cross-roads between Asia and Europa; a multicentre study from Turkey.

AIMS: The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO aetiology and factors influencing the final diagnosis of FUO in Turkey. METHODS: A total of 214 patients with FUO between the years 2015 and 2019 from 13 tertiary training and research hospitals were retrospectively evaluated. RESULTS: The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult-onset still's disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The aetiological spectrum did not differ in elderly people (P < .05). Infections were less frequent in Western (34.62%) compared with Eastern regions of Turkey (60.71%) (P < .001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed aetiology was significantly higher in elderly people (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (P: .004, OR: 3.07, 95% Cl: 1.39 to 6.71). CONCLUSIONS: Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumours and lymphomas, AOSD and thyroiditis are the other common diseases. The aetiological spectrum did not differ in elderly people, on the other hand, infections were more common in Eastern Turkey. A considerable amount of aetiology remained undiagnosed despite the state-of-the-art technology in healthcare services.

A cross-sectional study of real life data of HCV from Turkey south region.

INTRODUCTION: This study investigated demographic characteristics and the prevalence of viremia among anti-HCV-positive patients. METHODOLOGY: Hospital records of adult patients with anti-HCV positivity between June 2016 and October 2018 were screened retrospectively. Demographic characteristics, genotype distribution, history of injection drug use (IDU), treatment data of HCV RNA-positive patients were investigated. RESULTS: The rate of anti-HCV seropositivity was 1.7% and 54.5% of these were viremic. 69.5% of the 869 viremic patients were male. The mean age was 62 ± 15 (18-95) years for women and 42 ± 19 (18-90) years for men (p < 0.0001). 42.7% of these patients had IDU history. Regarding age, patients with IDU history accounted for 95% of the 18-29 age group. The most common genotype in patients younger than 40 was genotype 3, and genotype 1b in those older than 40. Only 52% of viremic patients had received DAA therapy. Also, 62.2% of patients aged < 40 and 36% of patients > 40 did not receive treatment (p < 0.0001). The SVR12 rate in patients receiving DAA treatment and follow-up was 100%; SVR24 was 99.5%. CONCLUSIONS: A shift in the demographic structure of HCV-infected patients due to the changing trends of the HCV transmission mode was observed in this study. On the other hand, the proportion of patients who received DAA therapy was low. A substantial proportion of untreated patients were young with a history of IDU. This indicates that without strategies targeting the patients, the patient load due to HCV-related cirrhosis and hepatocellular carcinoma may persist in the future.