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First Stage Diagnostic Tests In Fever Of Unknown Origin (FUO) : How To Remember Easily ?

  • D: During the diagnostic workup, search for potential diagnostic clues (PDCs) through history-taking and physical examination.
  • I: Investigations listed above and in the figure are obligatory for identifying PDCs.
  • A: Attention should be given to the eyes, lymph nodes, temporal arteries, liver, spleen, and other areas during the physical examination.
  • G: Glucocorticoid treatment and antibiotic use should be stopped before further diagnostic tests.
  • N: Not relying solely on unreliable tests such as blood cultures during antibiotic treatment.
  • O: Obligatory tests like ultrasounds and chest X-rays help differentiate easily diagnosed diseases.
  • S: Specialized tests and media should be used when necessary, such as for unusual microorganisms.
  • T: Tests beyond the obligatory ones usually yield false-positive results and are of little use without PDCs.
  • I: Investigation of cryoglobulins is valuable in patients with FUO and headache.
  • C: Culturing multiple blood samples and informing the laboratory about testing for unusual organisms is critical.
  • T: Testing for specific infections should be based on PDCs rather than microbiologic serology.
  • E: Echocardiography, sinus radiography, gastrointestinal tract evaluation, and bronchoscopy have low diagnostic yield without PDCs.
  • S: Specific investigations should be conducted based on the limited list of probable diagnoses.
  • T: To exclude factitious or fraudulent fever, careful examination and ruling out drug fever are necessary.
  • S: Screening procedures like fundoscopy may be useful in the absence of PDCs


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department