Abstract

MADERA, CD; GARCIA, SM; MONSALVE, P  and  SIMONOVIS, N. Fiebre prolongada: Una visión contemporánea de un viejo problema clínico de difícil diagnóstico. RFM [online]. 2000, vol.23, n.2, pp.102-106. ISSN 0798-0469.

The main objective of this research is the determination of the most frequent causes for the Prolongued Fever Syndrome (PFS) in the HUC and the design of strategies for the diagnostic approach to PFS patients in our environment. We present a prospective study undertaken in the Internal Medicine and Adult Infectious Diseases services in the HUC, between December 1993 and December 1995, with a sample of 100 patients that met the following parameters: 1)Age: 12 years or more; 2)Fever: 38,3 °C or more; 3)Fever: 21 days or more. A data extraction format was filled; in it were included:1) Identification; 2) Epidemiological records; 3)Constitutional symptoms; 4) Physical exam; 5) complementary studies (lab tests, cytomorphology, imagery). The results were analyzed according to descriptive statistical methods. 58% of the patients were male and 42% female. The age average was 36,9 years, with values between 13 and 80 years of age. Most of the patients came from Caracas (58%) and Miranda State (22%). The pathologies presented themselves in the following order: Infectious 55%, neoplasic 18%, conective tissue diseases 14%, miscelaneous 6%, non-diagnosed 7%. AIDS is the most frequently presented pathology (241%). This implies a change on the approach to a patient with PFS, because determining the presence of the HIV becomes prioritary to classify the patients in two groups: an HIV-negative group which will be studied according to classical patterns, and an HlV-positive group in which mainly infectious causes must be looked for. The infectious pathologies native to our environment must be investigated in both groups.

Keywords : Fever; Prolongued fever syndrome (PFS); AIDS; Fever prolongued diagnostic.