Pattern of pyrexia of unknown origin in Jeddah, Saudi Arabia

Objectives: To study the etiology of and the diagnostic techniques used in adult patients with pyrexia of unknown origin (PUO) admitted to King Abdulaziz University Hospital, (KAUH), Jeddah. Methods: Retrospective evaluation of charts of adult inpatients admitted with PUO from 1987 to 1994, Results: Forty-three patients who fulfilled the criteria of PUO infections were responsible for 24 cases (56%), malignancies for 5 cases, collagen vascular disease for 4 cases, 8 cases remained undiagnosed, out of which 4 cases improved spontaneously. Diagnosis by non invasive approach was the most common. Ultrasonography and computer tomography were useful diagnostic tools while tissue biopsy or needle aspiration were used for definite diagnosis in 11 patients. Conclusions: Infections remain the most common cause of PUO in the Kingdom of Saudi Arabia, mainly brucellosis, tuberculosis and salmonellosis. These should always be considered in PUO cases and excluded by appropriate non invasive tests guided by physical examination findings to avoid unnecessary invasive tests which are inconvenient and not often indicated.