A PROSPECTIVE STUDY ON THE MICROBIAL PROFILE OF PYREXIA OF UNKNOWN ORIGIN FROM INPATIENTS OF TERTIARY CARE HOSPITAL IN CHENNAI

INTRODUCTION Fever could have many causes including infective and non infective origin. PUO is a clinical syndrome that may result from much common aetiology which was characterized by prolonged fever without the signs or symptoms indicative of a well defined disease process.AIMS OBJECTIVES To find the infectious causes of fever by microscopy, serology and culture methods, To compare quantitative buffy coat vs peripheral smear study for the detection of malarial parasite and To find out Antimicrobial Susceptibility pattern of the organisms isolated.MATERIALS METHODS Patients with undiagnosed fever for more than three weeks duration were included in this study. Respective Specimens (blood, urine, pus, CSF, sputum, throat swab) were collected aseptically and processed according to standard laboratory procedures.RESULTS Among the 125 patients selected 66 were males and 59 were females. The causes of Pyrexia of unknown origin were Infectious in 62.4, Collagen disorder in 3.2, Neoplasm in 2.4, Miscellaneous in6.4 and undiagnosed in 25.6 of patients. In Infectious causes chronic urinary tract infection was the commonest cause(12.8) followed by malarial fever (11.2), Leptospirosis (10.4), enteric fever (8.0) and others were documented the source of PUO in the selected group.CONCLUSION In 62.4 of cases with fever more than 3 weeks were caused by infectious origin. Causes were unknown in 25.6 of patients.UTI was the most common cause in infectious origin. QBC is more sensitive to detect malarial parasite than Peripheral smear study. The sensitivity of Detection in Leptospiral aetiology by MSAT were high compared with IgM ELISA. Brucellosis, granulomatous diseases and certain neoplastic disorders would have contributed to the undiagnosed group in the diagnosis of PUO.