[Fever of unknown origin: differences in two different clinical series in a universitary hospital]. / Fiebre de origen desconocido clásica: cambios en dos series asíncronas en un hospital universitario.

We compare two clinical series of patients with fever of unknown origin (FUO) during two different periods of time (1982-1989 and 1997-2004) in the department of Internal Medicine at La Paz University Hospital, Madrid. We have analysed the changes in aetiology and diagnostic methods in these separated periods. We describe a decrease in the incidence of this clinical entity which we think to be due to the improvement of the diagnostic methods. This provides an earlier diagnosis and so patients do not reach criteria for classical FUO. Due to these improvements we have also assessed a change in the final diagnoses and the means used to reach them which, in general, have been less interventionist.

Fiebre de origen desconocido clásica: cambios en dos series asíncronas en un hospital universitario / Fever of unknown origin: differences in two different clinical series in a universitary hospital

Se analizan los cambios en la etiología y métodos que llevaron al diagnóstico en dos series de sujetos que cumplían los criterios de fiebre de origen desconocida clásica durante los períodos de 1982-1989 y 1997-2004 en un hospital universitario de la Comunidad de Madrid. Se advirtió que la incidencia ha disminuido de manera global, así como cambios en las categorías diagnósticas con clara regresión de las neoplasias y aumento de las infecciones y conectivopatías y que ha desaparecido la cirugía (laparotomía exploradora) y la necropsia como métodos de diagnóstico. Estos cambios se explican por la mejora en las técnicas diagnósticas, sobre todo las de imagen con toma dirigida de muestras, que permiten demostrar la etiología causante de la fiebre de origen desconocido (FOD) de manera rápida y eficaz en un mayor número de enfermos

We compare two clinical series of patients with fever of unknown origin (FUO) during two different periods of time (1982-1989 and 1997-2004) in the department of Internal Medicine at La Paz University Hospital, Madrid. We have analysed the changes in aetiology and diagnostic methods in these separated periods. We describe a decrease in the incidence of this clinical entity which we think to be due to the improvement of the diagnostic methods. This provides an earlier diagnosis and so patients do not reach criteria for classical FUO. Due to these improvements we have also assessed a change in the final diagnoses and the means used to reach them which, in general, have been less interventionist