Clinical profile of fever in patients admitted through the outpatient department in a North Indian tertiary care teaching hospital

Abstract

Background: Febrile illnesses are a common cause of morbidity and mortality and present diagnostic challenge, especially in the absence of reliable data in India. Fever has varying aetiologies such as infections, connective tissue disorders and malignancies. The infections may be indistinguishable clinically, and appropriate management will depend on the aetiologic profile. This study was planned to know the aetiology and seasonal variations of fever in adult patients. Methods: A prospective observational study over a period of 15 months was conducted on adult patients aged ≥18 years with febrile illness. Details of history and results of physical examination were recorded. Routine baseline and special investigations were done as clinically indicated. All patients were followed until discharge from the hospital. Results: Out of 122 patients, 79 were male. The maximum number of patients was in the age group of 31–40 years. The most common symptoms were myalgia, cough and vomiting. The aetiology of febrile illness was acute undifferentiated febrile illness (33.6%), undiagnosed undifferentiated fever (23%) and other diagnosis (43.4%). Common aetiologies of acute undifferentiated febrile illness were dengue fever (10.6%) and enteric fever (9.8%). Amongst other causes, tuberculosis and urinary tract infections were common. Seasonal variation was seen in enteric fever, dengue fever, pneumonia and tuberculosis. Conclusions: Common aetiologies were dengue, enteric fever and tuberculosis. It is important to understand the profile of febrile illness; so that evidence-based management can be initiated, especially in a resource-limited country like India.

Keywords

• acute undifferentiated febrile illness
• dengue fever
• enteric fever
• seasonal variation
• tuberculosis
• undiagnosed undifferentiated fever