pyrexia of unknown origin

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PYREXIA OF UNKNOWN ORIGIN : 

PYREXIA OF UNKNOWN ORIGIN INVESTIGATIONS

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ESR >100 mm/hr: Tuberculosis Malignancy Rheumatic fever Connective tissue disease Elevated alkaline phosphatase in: Biliary tract infections Hepatitis Lymphomas Miliary TB Infectious mononucleosis CMV infections

Blood culture : 

Blood culture Aerobic, anaerobic, fungal and mycobacterial infections. Temperature to be recorded 30 mins. 6 blood cultures. 10 ml of blood in 100 ml of culture medium reqd Are the cultures negative? Culture in a supplemental medium.

Skin tests : 

Skin tests Tuberculin test: perform in patients. For histoplasmosis & coccidiodomycosis. SEROLOGIC TESTS Enteric fever, HIV, infectious mononucleosis, Hepatitis A, B; CMV, Syphilis, Amoebiasis.

Imaging techniques : 

Imaging techniques X-RAYS: Plain films: Chest, abdomen, bone & sinuses. Contrast films: barium meal and barium enema intrinsic bowel disease. USG: Space occupying lesions in the heptobiliary tree >1 cm diameter. ECG: Atrial myxoma, endocarditic vegetations. CT Scan: lesions in retroperitoneum, liver, CNS. MRI: Spinal cord visualization, Pelvis.

Biopsies : 

Biopsies All biopsies to be cultured for aerobes, anaerobes, fungi and mycobacteria. Bone marrow: hematologic malignancies, TB, brucellosis, part. ttd. Typhoid, kala azar. Liver: miliary TB, sarcoidosis, granulomatous hepatitis, cancer, chronic active hepatitis. Lymph node: lymphomas, TB, histoplasmosis, toxoplasmosis.

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