7/3/2023 0 Comments Fever of unknown origin![]() ![]() In our recent work, we observed discrepancies in the classification of diseases across FUO categories among some recent prospective observational studies. A recent systematic literature review reported that the accuracy of this system was relatively high for capturing the actual diagnosis. ![]() Countries have adopted ICD updates at various times, and this system has become an integral part of the payment infrastructure of the US health care system. After several legislative delays, the ICD-10 was adopted in 1995 with enhanced granularity for disease tracking. Although the order of ICD-10 is similar to ICD-9, it is much more detailed, including nearly 3000 more categories. The ninth revision, used from 1979 to 1994, accommodated the needs of medical care programs and incorporated a method to classify conditions according to etiology and again by manifestation. Subsequent revisions (6–10) shifted to emphasize etiology as the central axis for classification, including causes of mortality and morbidity. Īlthough a revision cycle was established to keep pace with medical and scientific advancements, versions 1–5 were primarily concerned with mortality causes based on Bertillon's original classification system, which utilized anatomical sites instead of disease etiologies. Subsequently, the World Health Organization (WHO) took charge of the classification system in 1948 and renamed it the International Classification of Diseases (ICD) for morbidity and mortality. Subsequent investigators modified this method, but the classification system by Jacques Bertillon, Chief of Statistics for Paris, received general approval, with planned published updates once per decade until 1938. The work of French physician and botanist Francois Bossier de Sauvages de Lacroix, who in 1763 proposed 10 different illness classifications based on then-current taxonomy botany techniques, led to the first classification based on causes of death. The observation that disease classification was important for statistical reasons across borders and languages led to the introduction in 1893 of the International List of Causes of Death. classified diagnoses as falling within 7 groups: infections, neoplasms, noninfectious inflammatory disorders, drug fever, factitious fever, miscellaneous disorders, or undiagnosed illness. With no criteria for disease subclassification, Durack and Street proposed revisions in 1991, subdividing this problem into 4 distinct FUO types: classic, nosocomial, neutropenic, and HIV-related. In their classic 1961 series, Petersdorf and Beeson classified FUO diagnoses as falling within 12 groups: infectious, neoplastic diseases, collagen disease, pulmonary embolization, benign nonspecific pericarditis, sarcoidosis, hypersensitivity states, cranial arteritis, periodic disease, miscellaneous diseases, factitious fever, or no diagnosis. Hamman and Wainwright, in 1936, classified diagnoses as low- or high-grade fever, falling within 5 groups: septicemia, localized septic infections and abscesses, specific infections, diseases of blood-forming organs, or malignant tumors. ![]() Alt and Baker in 1930 classified patients as either established or unestablished diagnoses. In 1907, Cabot classified “long-continued fevers” by statistical methods into 3 main groups: sepsis, tuberculosis, and typhoid. Fever, fever of unknown origin, International Classification of Diseases, pyrexia, pyrexia of unknown originĮven though clinicians may commonly think of fever of unknown origin (FUO) diagnoses as falling into 1 of 5 categories (infections, neoplasms, noninfectious inflammatory disorders, miscellaneous conditions, and undiagnosed illnesses), there is no agreement regarding a uniform set of FUO disease classifications. ![]()
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