An FUO patient diagnosed as appendicitis: a case report

• Published in: BMC infectious diseases 2024-09, Vol.24 (1), p.993-5, Article 993
• Main Authors: Song, Shupeng, Zhao, Jinqiu, Tang, Yingzi, Li, Yongguo
• Format: Article
• Language: English
• Subjects: Abdomen; Abscesses; Adult; Anorexia; Anorexia nervosa; Antibiotics; Antibodies; Appendectomy; Appendicitis; Appendicitis - diagnosis; Appendicitis - surgery; Appendix; Appendix - diagnostic imaging; Appendix - pathology; Appendix - surgery; Blood; Body temperature; Care and treatment; Case Report; Case studies; Color; Color US; Communicable diseases; Computed tomography; CT imaging; CT scan; Development and progression; Diagnosis; Diagnostic imaging; Disease management; Eating disorders; Fever; Fever of Unknown Origin - diagnosis; Fever of Unknown Origin - etiology; FUO; Health aspects; Hospitals; Humans; Hyperthermia; Infection; Infections; Infectious diseases; Inflammation; Laparoscopy; Leukocytes; Male; Medical diagnosis; Medical imaging; Neutrophils; Patients; Surgical resection; Tomography, X-Ray Computed; Ultrasonic imaging
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09851-7

The diagnosis and management of fever of unknown origin pose significant challenges in the field of infectious diseases, as it is influenced by various factors. Infectious diseases have long been recognized as the primary etiology of fever of unknown origin. However, not all infectious diseases can definitively identify the causative pathogen and infection sites. we present a case report of an individual with fever, nausea, and anorexia but did not report any abdominal pain. Physical examination revealed no signs of abdominal tenderness. Repeated imaging studies including enhanced CT and color US of the appendix, only one color US suggested the possibility of appendicitis. Despite effective anti-infective treatment, the patient continued to experience low-grade fever, leading to the decision for laparoscopic exploration and subsequent appendectomy. Pathological findings confirmed the presence of appendicitis. After the surgical procedure, the patient's temperature and infectious markers returned to within normal range, ultimately leading to a diagnosis of appendicitis. The atypical symptoms and signs, along with the negative imaging results, contribute to the under diagnosis of appendicitis and the progression of fever of unknown origin, thereby exacerbating the physical, mental, and economic burden on patients. Consequently, there are valuable insights to be gained regarding the management of both appendicitis and fever of unknown origin.