• The Journal of Pediatrics of Korean Medicine
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• v.14 no.1
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• pp.189-196
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• 2000

Recently, By the climatic change and increased resistance to antibiotics, diseases with atypical fever are increasing. FUO(Fever unknown origin) is defined' as fever persisting for $1{\sim}3weeks$ which origins are not found. through the reports of two clinical cases presenting FUO, I pretend to show the orient-medical and west-medical approachs to FUO.

• Clinical and Experimental Pediatrics
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• v.50 no.2
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• pp.127-131
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• 2007

Fever of unknown origin (FUO) has been a convenient term used to classify patients who warrant a particular systemic approach to diagnostic evaluation and management. The greatest clinical concern in evaluating FUO is identifying patients whose fever has a serious or life-threatening cause when a delay in diagnosis could jeopardize successful intervention. Thorough history and complete physical examination are critical to uncover the etiologic diagnosis. Most cases of FUO in children are caused by atypical presentations of common diseases rather than by typical manifestations of rare disorders. Selection of diagnostic tests and speed of investigation should be guided by a knowledge of the disease severity, patient age, epidemiologic and geographic information, and any positive findings from a detailed history and physical examination. The three most common causes of FUO in children are infectious diseases, connective tissue diseases, and malignancy. In general, the prognosis of FUO in children is better than that of adults. Although the outcome is dependent on the primary disease process, fever abates spontaneously in most cases in whom the cause of fever remains unclear.

• Journal of Yeungnam Medical Science
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• v.25 no.1
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• pp.64-71
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• 2008

Evaluation of a fever of unknown origin (FUO) is complex. Recently, PET scanning has been approved for screening in FUO evaluation. We treated three cases of FUO associated with increased FDG uptake in the bone marrow of the femur and tibia on the fusion PET/CT; all three had the same pattern of uptake. Bone marrow biopsies revealed mature lymphocyte and histiocyte infiltration and myxoid changes in one case, and cortical bone involvement in another case. The cases were all young females who had fever with neutropenia and relative lymphocytosis that lasted for several weeks and then remitted spontaneously. Even though the results of the studies were not diagnostic, the unique uptake pattern on PET/CT and the histology might be related to the cause of the illness and should be studied further to assess the association with classic FUO.

• Journal of Sasang Constitutional Medicine
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• v.19 no.2
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• pp.223-229
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• 2007

1. Objectives FUO is defined as a temperature higher than $38.3^{\circ}C$ on several occasions and lasting longer than 3 weeks, with a diagnosis that remain uncertain after 1 week of investigation. Diagnosing the cause of FUO is particularly difficult. 2. Methods We have tried researching effect of herbal medicines(Kalkunhaeki - tang treatments) and Acupoint Injection to Taeumin FUO patient. 3. Results A Taeumin patient diagnosed to FUO was treated with Taeumin herbal medicines(kalkunhaeki - tang treatments) and change of patient's fever and general condition were improved. 4. Conclusions The constitutional treatment with Kalkunhaeki - tang may have an effect on management of FUO. So we report the healing process and results of this patient in this study.

• Clinical and Experimental Pediatrics
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• v.60 no.3
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• pp.77-85
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• 2017

Purpose: Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. Methods: Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ${\geq}38.0^{\circ}C$ for longer than ${\geq}14days$ and failure to reach a diagnosis after one week of investigations were included. Results: Total 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%). Conclusion: Almost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.6
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• pp.683-688
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• 2014

Fever of Unknown Origin(FUO) is defined as a temperature higher than 38.3'C that persists without diagnosis for at least 3 weeks despite appropriate investigation. The purpose of this study was to analyze the effectiveness of oriental medical treatment on the patient with FUO. We treated a female patient with FUO by oriental medical treatment with appropriate herbal medicine and balanced acupuncture. We prescribed Galgunhaegi-tang (Gegenjieji-tang) for 5 days and Handayeolso-tang(Handuoreshao-tang) for 9 days. At the same period, we also applied acupuncture and checked body temperature. In order to measure a pain of the patient, we used Visual Analogue Scale(VAS). It was found that Galgunhaegi-tang had little effect at this time, but the administration of Handayeolso-tang brought the positive effect on the patient. The body temperature of the patient was lowered and VAS score was reduced apparently after treatment. Handayeolso-tang might be used for relieving symptoms of FUO.

• Journal of Institute of Control, Robotics and Systems
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• v.13 no.5
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• pp.452-461
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• 2007

Adaptive anti-sway and trajectory tracking control of overhead crane is presented, which utilizes Fuzzy Uncertainty Observer(FUO) and Fuzzy based Variable Structure Control(FVSC). We consider an overhead crane system which can be decoupled into the actuated and unactuated subsystems with its own lumped uncertainty such as parameter uncertainties and external disturbance. First, a new method for anti-sway control using FVSC is proposed to improve the conventional method based on Lyapunov direct method, while a conventional trajectory tracking control law using feedback linearization is directly adopted. Second, FUO is designed to estimate one of the two lumped uncertainties which can compensate both of them, based on the fact that two lumped uncertainties are coupled with each other. Then, an adaptive anti-sway control is proposed by incorporating the proposed FVSC and FUO. Under the condition that the observation error is Uniformly Ultimately Bounded(UUB) within an arbitrarily shrinkable region, the overall closed-loop system is shown to be Globally Uniformly Ultimately Bounded(GUUB). In addition, the Global Asymptotic Stability(GAS) of it is shown under the vanishing disturbance assumption. Finally, the effectiveness of the proposed scheme has been confirmed by numerical simulations.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.683-686
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• 2014

Objective: The purpose of the study was to evaluate clinical value of dual-phase $^{18}F$-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO). Methods: PCT test and dual-phase $^{18}F$-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all $^{18}F$-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual-phase $^{18}F$-FDG SPECT and bacterial cultivation, regarded as a gold standard. Results: Among 50 patients, 34 demonstrated PCT ${\geq}0.5{\mu}g/L$. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase $^{18}F$-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up. Conclusion: Our study demonstrated that dual-phase $^{18}F$-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.79-80
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• 2008

Including malignancy, various disease can show abnormal uptake in bone marrow. We report a case of non-specific inflammatory FDG uptake in bone marrow mimicking malignancy. A 35-year old woman with fever of unknown origin (FUO) underwent $^{18}F$-FDG PET/CT to find out fever $^{18}F$-FDG and unknown malignancy. $^{18}F$-FDG was injected and imaged 1hr after injection with Discovery ST (GE, USA), $^{18}F$-FDG PET/CT whole body image showed abnormal uptake in lower extremities (Fig. 1). MRI and biopsy was also done in the sites of abnormal uptake. PET and MRI suspect malignancy (Fig. 2, 3), but biopsy result was non-specific inflammatory process (Fig. 4). The patient was improved her clinical condition after antibiotics therapy.

• The Journal of the Korean Society for Microbiology
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• v.21 no.4
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• pp.447-453
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• 1986

To diagnose the typhoid fever rapidly and accurately in clinically suspected patients, the levels of IgG subclass antibody were measured by enzyme-linked immunosorbent assay(ELISA). With symptom, blood culture and agglutination test, tested persons were categorized into 6 groups as typhoid fever, FUO, paratyphi A or B, other bacterial infctions, cancers, and control. ELISA was performed on the polyvinyl chloride plates coated with killed whole cell($10^8\;cell/ml$) of S. typhi 0901W by poly-L-lysine applied as binding substance (and polyvinyl chloride as solid phase). The distribution of the level of IgG subclass antibodies in each group was analyzed and compared with other groups. The results obtained were summarized as follow: 1. The optimal dilution of the sera from patients with typhoid fever was 1:160, and those of the sheep anti-human IgG subclass and the peroxidase conjugated rabbit anti-sheep IgG were 1:4000 and 1:5000, respectively. 2. The absorbance levels of IgG subclass in the sera of typhoid fever patients were as follows; a) IgG1 value is $0.439{\pm}0.110$ b) IgG2 value is $0.416{\pm}0.165$ c) IgG3 value is $0.449{\pm}0.145$ d) IgG4 value is $0.525{\pm}0.154$ IgG subclass levels in the sera of typhoid patients were much higher than in control group and patient with paratyphi A or B as well as other infectious diseases. The sensitivity and the specificity in differential diagnosis of typhoid fever and other febrile diseases were 92% and 79% in the assay of IgG1 respectively, whereas those in the assay of IgG2 were 97% and 72%, respectively (above absorbance 0.3). 3. The absorbance levels of IgG subclass in the serial sera of typhiod fever patients tend to decrease to the level of absorbance 0.3 in 10 months from the onset of illness. 4. The order of absorbance levels of IgG subclass in the serum of each group were typhoid fever, paratyphi A or B, other infectious diseases, control and cancer. 5. For the serodiagnosis of typhoid fever against other febrile diseases, the sensitivity and the specificity in the assay of IgG2 activity were 76% and 93% in absorbance 0.4, respectively. 6. In the distribution of the level of each IgG subclass in the sera of FUO patients which were suspected of typhoid fever, the positive rate was ranged from 36% to 82%. This suggest that more than 50% of FUO patients are caused by S. typhi.