Every now & then you will face a situation where you strongly suspect an infection in your patient but the infection plays hide & seek & remains asymptomatic until too late.
Examples:
– Fever of Unknown Origin (FUO): Ongoing fevers or just chills/sweats but no other symptoms
– Sepsis of Unknown Origin (SUO): Patient appears to have sepsis, but you can’t find the infection
– Patient develops hypotension or shock, the usual causes of hypotension don’t seem to apply and you need to make sure it isn’t septic shock
Hate when that happens! But here’s a good list of infections that cause Fever and Sepsis of Unknown Origin & a great mnemonic to recall that list. Happy Hunting!
Mnemonic for causes of FUO & SUO: ” MILD PATHOGENS “
M – Meningitis & Encephalitis, Mycobacterial infections
I – Infective Endocarditis
L – Lyme disease & other tick-borne infections
D – Dental infections
P – Pressure ulcer infections, Prostatitis, Perforations & Peritonitis
A – Abscesses, esp Abdominal (consider whole-body CT scan or ‘Pan-CT’)
T – Thrombophlebitis (septic) or infected clots
H – Hardware infections (central lines, prosthetic joints, shunts, pacemakers, etc)
O – Osteomyelitis
G – Gall bladder infection (Asymptomatic Cholecystitis can occur in ICU and post-op patients)
E – Epidural abscess & diskitis, Empyema
N – Necrotizing Fasciitis including Fournier’s Gangrene( small skin redness could be brewing Nec-Fas!)
S – STDs including HIV
It is also important to remember however that not all fevers mean an infection – We had already covered Non-Infectious causes of Fever earlier !
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