Clinical Profile and Etiology of Prolonged Pyrexia in Adults Attending a Tertiary Care Hospital in Bangladesh

Background: Prolonged Pyrexia or Fever of Unknown Origin (FUO) represents a significant diagnostic challenge due to its prevalence in tropical countries like Bangladesh. Objective: The study evaluates the medical characteristics alongside causes of prolonged fever among adult patients seeking treatment at a tertiary medical facility. Methodology: A Prospective observational study was conducted at BIRDEM General Hospital in Dhaka from July 2021 to June 2023. The research included 80 adult patients (40 to 75 years old) who had sustained high temperatures for at least 14 consecutive days. Data collection included clinical factors alongside demographic statistics and laboratory results, which were analyzed through SPSS 25.0. Result: The study found a male-to-female ratio of 1.86:1; this is a male-dominant study with 63% of male participants. The mean age of study participants was 43.47 ± 14.78 years, where the majority of the patients belongs to the 50-59 years of age group. Most patients came from rural parts (72.5%), and 27.5% of patients came from urban Bangladesh. A total of 66.3% of patients had infectious causes, while tuberculosis remained the most prevalent infection at 29 patients. The study documented 13.8% of cases due to autoimmune conditions and 12.5% due to malignancies. Still’s diseases (6 patients) and Vacuities (5 patients) are most prominent in autoimmune disease condition. The patients needed an average of 22 days to receive a correct diagnosis, while those with neoplasm required 28 days for diagnosis. Patients diagnosed with neoplasm presented with severe morbidity at 70% frequency among neoplasm groups (p<0.001). The researchers identified hypoalbuminemia below 2.8 g/dL with an odds ratio of 42.0 as well as CRP levels exceeding 90 mg/L with an odds ratio of 19.8 as primary predictors. The clinical condition of 17.5% of patients deteriorated to a severe level that demanded intensive care, yet no case of mortality was recorded in the study. Conclusion