• N Ratti, K H Ly, S Dumonteil, M François, L Sailler, M Lambert, A Hot, G Gondran, S Palat, H Bezanahary, E Desvaux, N Aslanbekova, S Parreau, A L Fauchais, P Sève, and E Liozon.
• Departments of Internal Medicine, University Hospitals of Limoges (Dupuytren).
• Clin Med (Lond). 2024 Apr 18: 100202100202.

BackgroundRecurrent-FUO (fever of unknown origin) is a rare subtype of FUO for which diagnostic procedures are ill-defined and outcome data are lacking.MethodsWe performed a retrospective multicentre study of patients with recurrent-FUO between 1995 and 2018. By multivariate analysis, we identified epidemiological, clinical, and prognostic variables independently associated with final diagnosis and mortality.ResultsOf 170 patients, 74 (44%) had a final diagnosis. Being ≥ 65 years of age (OR=5.2; p<0.001), contributory history (OR=10.4; p < 0.001), and abnormal clinical examination (OR=4.0; p=0.015) independently increased the likelihood of reaching a diagnosis, whereas lymph node and/or spleen enlargement decreased it (OR = 0.2; p=0.004). The overall prognosis was good; 58% of patients recovered (70% of those with a diagnosis). Twelve (7%) patients died; patients without a diagnosis had a fatality rate of 2%. Being ≥ 65 years of age (OR = 41.3; p < 0.001) and presence of skin signs (OR = 9.5; p = 0.005) significantly increased the risk of death.ConclusionThis study extends the known yield of recurrent-FUO and highlights the importance of repeated complete clinical examinations to discover potential diagnostic clues during follow- up. Moreover, their overall prognosis is excellent.Copyright © 2024. Published by Elsevier Ltd.

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