Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study

Hakan Erdem; Magdalena Baymakova; Sevil Alkan; Amel Letaief; Wissal Ben Yahia; Farouq Dayyab; Entela Kolovani; Svjetlana Grgic; Federica Cosentino; Imran Hasanoglu; Reham Khedr; Andrea Marino; Abdullah Umut Pekok; Fatma Eser; Jurica Arapovic; Hatice Rahmet Guner; Ionela Larisa Miftode; Kostadin Poposki; Gamze Sanlidag; Alper Tahmaz; Oguz Resat Sipahi; Egidia Gabriela Miftode; Serkan Oncu; Meliha Cagla-Sonmezer; Syam Kumar Addepalli; Ilad Alavi Darazam; Hema Prakash Kumari; Meliha Meriç Koc; Meela Ranjith Kumar; Suresh Babu Sayana; Ahmed Ashraf Wegdan; Fatma Amer; Mehmet Resat Ceylan; Amani El-Kholy; Taylan Onder; Hamed Azhdari Tehrani; Atousa Hakamifard; Bircan Kayaaslan; Ghaydaa Shehata; Hulya Caskurlu; Nagwa Mostafa El-Sayed; Seyed Erfan Mortazavi; Mohammad Pourali; Umran Elbahr; Sholpan Kulzhanova; Tarkan Yetisyigit; Sahar Ahmed Saad; Yasemin Cag; Gulden Eser-Karlidag; Natalia Pshenichnaya; Maya Belitova; Nasim Akhtar; Fahad Al-Majid; Muge Ayhan; Mumtaz Ali Khan; Massimiliano Lanzafame; Mateja Jankovic Makek; Emmanuel Nsutebu; Antonio Cascio; Emine Kubra Dindar-Demiray; Emine Unal Evren; Rama Kalas; Ayşe Kaya Kalem; Rusmir Baljić; Aamer Ikram; Selcuk Kaya; Anna Liskova; Balint Gergely Szabo; Bilal Ahmad Rahimi; Esmeray Mutlu-Yilmaz; Alper Sener; Jordi Rello

doi:10.1007/s10096-023-04561-5

Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study

Hakan Erdem
, Magdalena Baymakova
, Sevil Alkan
, Amel Letaief
, Wissal Ben Yahia
, Farouq Dayyab
, Entela Kolovani
, Svjetlana Grgic
, Federica Cosentino
, Imran Hasanoglu
, Reham Khedr
, Andrea Marino
, Abdullah Umut Pekok
, Fatma Eser
, Jurica Arapovic
, Hatice Rahmet Guner
, Ionela Larisa Miftode
, Kostadin Poposki
, Gamze Sanlidag
, Alper Tahmaz

Oguz Resat Sipahi, Egidia Gabriela Miftode, Serkan Oncu, Meliha Cagla-Sonmezer, Syam Kumar Addepalli, Ilad Alavi Darazam, Hema Prakash Kumari, Meliha Meriç Koc, Meela Ranjith Kumar, Suresh Babu Sayana, Ahmed Ashraf Wegdan, Fatma Amer, Mehmet Resat Ceylan, Amani El-Kholy, Taylan Onder, Hamed Azhdari Tehrani, Atousa Hakamifard, Bircan Kayaaslan, Ghaydaa Shehata, Hulya Caskurlu, Nagwa Mostafa El-Sayed, Seyed Erfan Mortazavi, Mohammad Pourali, Umran Elbahr, Sholpan Kulzhanova, Tarkan Yetisyigit, Sahar Ahmed Saad, Yasemin Cag, Gulden Eser-Karlidag, Natalia Pshenichnaya, Maya Belitova, Nasim Akhtar, Fahad Al-Majid, Muge Ayhan, Mumtaz Ali Khan, Massimiliano Lanzafame, Mateja Jankovic Makek, Emmanuel Nsutebu, Antonio Cascio, Emine Kubra Dindar-Demiray, Emine Unal Evren, Rama Kalas, Ayşe Kaya Kalem, Rusmir Baljić, Aamer Ikram, Selcuk Kaya, Anna Liskova, Balint Gergely Szabo, Bilal Ahmad Rahimi, Esmeray Mutlu-Yilmaz, Alper Sener, Jordi Rello

University of Health Sciences
Military Medical Academy, Sofia
Canakkale Onsekiz Mart University
University of Sousse
King Hamad University Hospital
University Medical Center of Tirana "Mother Teresa"
University Clinical Hospital Mostar
University of Catania
Ankara City Hospital
Cairo University
Pendik Hospital
St. Parascheva Infectious Disease Hospital
SS Cyril and Methodius University in Skopje
Ege University
Antalya Training and Research Hospital
Adnan Menderes University
Hacettepe University
Gandhi Institute of Technology and Management
Shahid Beheshti University of Medical Sciences
Bezmialem Vakif University
Government General Hospital
Government Medical College
Al-Fayoum University
Zagazig University
Harran University
Assiut University
Istanbul Medeniyet University
Research Institute of Ophthalmology
Astana Medical University
Central Research Institute of Epidemiology
Medical University Sofia
Pakistan Institute of Medical Sciences
King Saud University
Ministry of National Health Services, Regulations and Coordination
Santa Chiara Hospital
University of Zagreb
University of Palermo
Bitlis Public Hospital
University of Kyrenia
KCU Sarajevo.
National Institutes of Health
Karadeniz Technical University
St. Elisabeth University of Health Care and Social Work
National Institute of Hematology and Infectious Diseases
Kandahar University
Samsun Training and Research Hospital
Vall d'Hebron Research Institute
Clinical Research

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19–3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65–1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65–1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.

Original language	English
Pages (from-to)	387-398
Number of pages	12
Journal	European Journal of Clinical Microbiology and Infectious Diseases
Volume	42
Issue number	4
DOIs	https://doi.org/10.1007/s10096-023-04561-5
State	Published - Apr 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Economic development
FUO
Fever
Fever of unknown origin
ID-IRI

Access to Document

10.1007/s10096-023-04561-5

Cite this

Erdem, H., Baymakova, M., Alkan, S., Letaief, A., Yahia, W. B., Dayyab, F., Kolovani, E., Grgic, S., Cosentino, F., Hasanoglu, I., Khedr, R., Marino, A., Pekok, A. U., Eser, F., Arapovic, J., Guner, H. R., Miftode, I. L., Poposki, K., Sanlidag, G., ... Rello, J. (2023). Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study. European Journal of Clinical Microbiology and Infectious Diseases, 42(4), 387-398. https://doi.org/10.1007/s10096-023-04561-5

@article{81b8cb0ffdc24999b6ea5f2e234a3ec0,

title = "Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study",

abstract = "Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6\%; n = 407), neoplasms (11.4\%, n = 90), collagen vascular disorders (9.3\%, n = 73), undiagnosed (20.1\%, n = 158), miscellaneous diseases (7.7\%, n = 60). The most common infections were tuberculosis (n = 45, 5.7\%), brucellosis (n = 39, 4.9\%), rickettsiosis (n = 23, 2.9\%), HIV infection (n = 20, 2.5\%), and typhoid fever (n = 13, 1.6\%). Cardiovascular infections (n = 56, 7.1\%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95\% CI: 1.19–3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95\% CI; 0.87 (0.65–1.15)), death attributed to FUO (RR = 0.87, 95\% CI: 0.65–1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.",

keywords = "Economic development, FUO, Fever, Fever of unknown origin, ID-IRI",

author = "Hakan Erdem and Magdalena Baymakova and Sevil Alkan and Amel Letaief and Yahia, \{Wissal Ben\} and Farouq Dayyab and Entela Kolovani and Svjetlana Grgic and Federica Cosentino and Imran Hasanoglu and Reham Khedr and Andrea Marino and Pekok, \{Abdullah Umut\} and Fatma Eser and Jurica Arapovic and Guner, \{Hatice Rahmet\} and Miftode, \{Ionela Larisa\} and Kostadin Poposki and Gamze Sanlidag and Alper Tahmaz and Sipahi, \{Oguz Resat\} and Miftode, \{Egidia Gabriela\} and Serkan Oncu and Meliha Cagla-Sonmezer and Addepalli, \{Syam Kumar\} and Darazam, \{Ilad Alavi\} and Kumari, \{Hema Prakash\} and Koc, \{Meliha Meri{\c c}\} and Kumar, \{Meela Ranjith\} and Sayana, \{Suresh Babu\} and Wegdan, \{Ahmed Ashraf\} and Fatma Amer and Ceylan, \{Mehmet Resat\} and Amani El-Kholy and Taylan Onder and Tehrani, \{Hamed Azhdari\} and Atousa Hakamifard and Bircan Kayaaslan and Ghaydaa Shehata and Hulya Caskurlu and El-Sayed, \{Nagwa Mostafa\} and Mortazavi, \{Seyed Erfan\} and Mohammad Pourali and Umran Elbahr and Sholpan Kulzhanova and Tarkan Yetisyigit and Saad, \{Sahar Ahmed\} and Yasemin Cag and Gulden Eser-Karlidag and Natalia Pshenichnaya and Maya Belitova and Nasim Akhtar and Fahad Al-Majid and Muge Ayhan and Khan, \{Mumtaz Ali\} and Massimiliano Lanzafame and Makek, \{Mateja Jankovic\} and Emmanuel Nsutebu and Antonio Cascio and Dindar-Demiray, \{Emine Kubra\} and Evren, \{Emine Unal\} and Rama Kalas and Kalem, \{Ay{\c s}e Kaya\} and Rusmir Balji{\'c} and Aamer Ikram and Selcuk Kaya and Anna Liskova and Szabo, \{Balint Gergely\} and Rahimi, \{Bilal Ahmad\} and Esmeray Mutlu-Yilmaz and Alper Sener and Jordi Rello",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2023",

month = apr,

doi = "10.1007/s10096-023-04561-5",

language = "English",

volume = "42",

pages = "387--398",

journal = "European Journal of Clinical Microbiology and Infectious Diseases",

issn = "0934-9723",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "4",

}

Erdem, H, Baymakova, M, Alkan, S, Letaief, A, Yahia, WB, Dayyab, F, Kolovani, E, Grgic, S, Cosentino, F, Hasanoglu, I, Khedr, R, Marino, A, Pekok, AU, Eser, F, Arapovic, J, Guner, HR, Miftode, IL, Poposki, K, Sanlidag, G, Tahmaz, A, Sipahi, OR, Miftode, EG, Oncu, S, Cagla-Sonmezer, M, Addepalli, SK, Darazam, IA, Kumari, HP, Koc, MM, Kumar, MR, Sayana, SB, Wegdan, AA, Amer, F, Ceylan, MR, El-Kholy, A, Onder, T, Tehrani, HA, Hakamifard, A, Kayaaslan, B, Shehata, G, Caskurlu, H, El-Sayed, NM, Mortazavi, SE, Pourali, M, Elbahr, U, Kulzhanova, S, Yetisyigit, T, Saad, SA, Cag, Y, Eser-Karlidag, G, Pshenichnaya, N, Belitova, M, Akhtar, N, Al-Majid, F, Ayhan, M, Khan, MA, Lanzafame, M, Makek, MJ, Nsutebu, E, Cascio, A, Dindar-Demiray, EK, Evren, EU, Kalas, R, Kalem, AK, Baljić, R, Ikram, A, Kaya, S, Liskova, A, Szabo, BG, Rahimi, BA, Mutlu-Yilmaz, E, Sener, A & Rello, J 2023, 'Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study', European Journal of Clinical Microbiology and Infectious Diseases, vol. 42, no. 4, pp. 387-398. https://doi.org/10.1007/s10096-023-04561-5

TY - JOUR

T1 - Classical fever of unknown origin in 21 countries with different economic development

T2 - an international ID-IRI study

AU - Erdem, Hakan

AU - Baymakova, Magdalena

AU - Alkan, Sevil

AU - Letaief, Amel

AU - Yahia, Wissal Ben

AU - Dayyab, Farouq

AU - Kolovani, Entela

AU - Grgic, Svjetlana

AU - Cosentino, Federica

AU - Hasanoglu, Imran

AU - Khedr, Reham

AU - Marino, Andrea

AU - Pekok, Abdullah Umut

AU - Eser, Fatma

AU - Arapovic, Jurica

AU - Guner, Hatice Rahmet

AU - Miftode, Ionela Larisa

AU - Poposki, Kostadin

AU - Sanlidag, Gamze

AU - Tahmaz, Alper

AU - Sipahi, Oguz Resat

AU - Miftode, Egidia Gabriela

AU - Oncu, Serkan

AU - Cagla-Sonmezer, Meliha

AU - Addepalli, Syam Kumar

AU - Darazam, Ilad Alavi

AU - Kumari, Hema Prakash

AU - Koc, Meliha Meriç

AU - Kumar, Meela Ranjith

AU - Sayana, Suresh Babu

AU - Wegdan, Ahmed Ashraf

AU - Amer, Fatma

AU - Ceylan, Mehmet Resat

AU - El-Kholy, Amani

AU - Onder, Taylan

AU - Tehrani, Hamed Azhdari

AU - Hakamifard, Atousa

AU - Kayaaslan, Bircan

AU - Shehata, Ghaydaa

AU - Caskurlu, Hulya

AU - El-Sayed, Nagwa Mostafa

AU - Mortazavi, Seyed Erfan

AU - Pourali, Mohammad

AU - Elbahr, Umran

AU - Kulzhanova, Sholpan

AU - Yetisyigit, Tarkan

AU - Saad, Sahar Ahmed

AU - Cag, Yasemin

AU - Eser-Karlidag, Gulden

AU - Pshenichnaya, Natalia

AU - Belitova, Maya

AU - Akhtar, Nasim

AU - Al-Majid, Fahad

AU - Ayhan, Muge

AU - Khan, Mumtaz Ali

AU - Lanzafame, Massimiliano

AU - Makek, Mateja Jankovic

AU - Nsutebu, Emmanuel

AU - Cascio, Antonio

AU - Dindar-Demiray, Emine Kubra

AU - Evren, Emine Unal

AU - Kalas, Rama

AU - Kalem, Ayşe Kaya

AU - Baljić, Rusmir

AU - Ikram, Aamer

AU - Kaya, Selcuk

AU - Liskova, Anna

AU - Szabo, Balint Gergely

AU - Rahimi, Bilal Ahmad

AU - Mutlu-Yilmaz, Esmeray

AU - Sener, Alper

AU - Rello, Jordi

PY - 2023/4

Y1 - 2023/4

N2 - Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19–3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65–1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65–1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.

AB - Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19–3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65–1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65–1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.

KW - Economic development

KW - FUO

KW - Fever

KW - Fever of unknown origin

KW - ID-IRI

UR - https://www.scopus.com/pages/publications/85148079261

U2 - 10.1007/s10096-023-04561-5

DO - 10.1007/s10096-023-04561-5

M3 - Article

C2 - 36790531

AN - SCOPUS:85148079261

SN - 0934-9723

VL - 42

SP - 387

EP - 398

JO - European Journal of Clinical Microbiology and Infectious Diseases

JF - European Journal of Clinical Microbiology and Infectious Diseases

IS - 4

ER -

Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study

Abstract

UN SDGs

Keywords

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