Expanding the causes of Fever of Unknown Origin in immunocompromised patients: report of two cases highlighting the role of SARS-CoV-2

Fever of Unknown Origin (FUO) remains a diagnostic challenge for clinicians, with multiple infectious and non-infectious etiologies. SARS-CoV-2 can determine a prolonged viral shedding in the immunocompromised host, firstly in those receiving B-cell targeted therapies, being responsible of persistent infection which may configure as a FUO. We report two cases of long-lasting fever in patients with multiple sclerosis and B-cell depletion, finally diagnosed as COVID-19. We suggest the inclusion of SARS-CoV-2 testing in the differential diagnosis of FUO.

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Publication Details

Journal
Infezioni in Medicina
Published
2025-12-01
DOI
https://doi.org/10.53854/liim-3304-10
Primary Topic
Hematological disorders and diagnostics
Type
article
Field-Weighted Citation Impact
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article

Expanding the causes of Fever of Unknown Origin in immunocompromised patients: report of two cases highlighting the role of SARS-CoV-2

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Infezioni in Medicina
Hematological disorders and diagnostics
article

Expanding the causes of Fever of Unknown Origin in immunocompromised patients: report of two cases highlighting the role of SARS-CoV-2

Carmelina Calitri, Barbara Rizzello, Roberto Angilletta, Andrea Calcagno, Francesca Romano, Marco Mussa, Fabio Antonino Ranzani, Andrea Perinzano, Marco Domenico Carbutto
article en

Abstract

Fever of Unknown Origin (FUO) remains a diagnostic challenge for clinicians, with multiple infectious and non-infectious etiologies. SARS-CoV-2 can determine a prolonged viral shedding in the immunocompromised host, firstly in those receiving B-cell targeted therapies, being responsible of persistent infection which may configure as a FUO. We report two cases of long-lasting fever in patients with multiple sclerosis and B-cell depletion, finally diagnosed as COVID-19. We suggest the inclusion of SARS-CoV-2 testing in the differential diagnosis of FUO.

Infezioni in MedicinaVol. 33(4)
Ospedale Amedeo di Savoia (IT)
Openalex Percentile: Top 44%
Hematological disorders and diagnostics
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