Fiebre de origen desconocido en pacientes mayores de 60 a？os: Reporte de 40 casos

fever of unknown origin (fuo) presents a diagnostic dilemma in elderly patients. between 2000 and 2007 a prospective and descriptive study was conducted to identify the diseases that may cause fuo and to assess the diagnostic contribution of history, physical examination and diagnostic tests. it were included all 60 years old patients and over that fulfilled classic criteria of fuo. forty patients met classic criteria of fuo. infections, neoplasms and noninfectious inflammatory diseases were found in 17 (42.5 %), 9 (22.5 %) and 8 patients (20 %), respectively. miscellaneous conditions and undiagnosed categories were found in 3 patients (7.5 %) in each category. the history and physical examination had a diagnostic contribution in 30 patients (75 %). clinical features led to unnecessary investigations in 21 patients (52 %). abdominal ultrasonography and abdominal computed tomography had a diagnostic yield of 25% and 35%, respectively. bone marrow biopsy and liver biopsy yielded the final diagnosis in 16 % and 13 % cases studied, respectively. the history and physical examination had a diagnostic contribution when they were considered together. abdominal computed tomography should be done early in fuo. bone marrow biopsy and liver biopsy should be performed in a further stage of the diagnostic process.