Acute Undifferentiated Febrile Illness in Sisaket Hospital

Abstract

Background: Acute Undifferentiated Febrile Illness is defined by acute onset of fever (body temperature more than 38.3 degree celcius and duration of fever less than two weeks) and no causes can be found after hill history taking and physical examination .The terms Acute febrile illness, Acute Fever of Unknown origin, Acute Undifferentiated Fever were also used in many studies with the same definition. In Thailand Acute Undifferentiated Fever was reported to affect approximately 200,000-400,000 patients each year. In many studies infection was the most common cause. But different kinds of infection were vary depend on where and when the studies took place. Many cases of Acute Undifferentiated febrile illness remain undiagnosed.
Objective: To identify the causes and treatment outcome of Acute Undifferentiated Febrile illness in Medical Department, Sisaket Hospital from January 1, 2007 to December 31, 2007.
Patients and methods: The study consisted of 124 patients. The data was collected to identify the sex, age range, duration of fever .The diagnosis procedure was done by medical history, physical examination and laboratory test investigation using laboratory facilities of Sisaket Hospital .
Results: The ratio between males and females was 1 : 0.68, Most of the patients was 25-34 years old. (33.87%) Average duration of fever before admission was 4.86 days. The causes of Acute Undifferentiated Febrile illness were infection 51.61% Connective tissue disease 2.42% malignancy 2.42% inflammatory disease 0.8% and undiagnosed 42.74%. Common causes of infection were rickettsial infection (Scrub typhus.) 19.35%. Leptospirosis 18.55% Dengue fever 8.06% Melioidosis 3.23% Tuberculosis 1.61% malaria 0.8%. In Scrub typhus, the average age was 32.58 years old. The important risk factors were farmer 91.67%, animal contact 58.33% eschar was found 75%. In dengue fever the average age was 18.61 years old. In Melioidosis the average age was 48.51 years old, Splenic abscess was found in 100%. The associated underlying disease were Diabetes Mellitus 75%, Chronic renal failure 50%. In malignancy, The average age was 65.24 years old. The History of weight loss more than 2 kg in one month was 100%. The results of treatments in Scrub typhus and Dengue fever, all patients were cured. In Melioidosis, all patients showed improvement. In Leptospirosis, two patients died (8.70%). In case of patients who couldn’t be identified the causes of fever, 96.23% were cured. The average time of fever during hospital admission was 4.56 days. 3.77% of these patients died.
Conclusion: The most common cause of Acute Undifferentiated Febrile illness was infection. Scrub Typhus is the leading cause of infection which was found in middle age patients. Most of them were farmer. Leptospirosis and Mellioid were also common in Sisaket district.
Key word: Acute Undifferentiated Febrile illness