Evidence map›Paper›PMID 40696644›Full record

Observational studyMedicine2025

Diagnosis and outcomes of fever of unknown origin cases with an erythrocyte sedimentation rate of 100 mm/h or more: An International ID-IRI (Infectious Diseases - International Research Initiative) Observational Retrospective Cohort Study.

Umran Elbahr, Hakan Erdem, Wissal Ben Yahia, Magdalena Petrova Baymakova, Amel Letaief, Kostadin Poposki, Svjetlana Grgić, Gamze Sanlidag, Ionela-Larisa Miftode, Andrea Marino and 24 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Umran ElbahrInfectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain.ORCID 0000-0001-6493-197
Hakan ErdemDepartment of Infectious Diseases and Clinical Microbiology, Turkish Health Sciences University, Gulhane School of Medicine, Ankara, Türkiye.
Wissal Ben YahiaInternal Medicine Department, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia.
Magdalena Petrova BaymakovaDepartment of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria.
Amel LetaiefInfectious Diseases Department, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia.
Kostadin PoposkiFaculty of Medicine, University Clinic for Infectious Diseases and Febrile Conditions, Skopje, Republic of North Macedonia.
Svjetlana GrgićInfectious Diseases Department, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
Gamze SanlidagDepartment of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Türkiye.
Ionela-Larisa MiftodeSt. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania.
Andrea MarinoDepartment of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy.
Egidia Gabriela MiftodeSt. Parascheva Clinical Hospital of Infectious Diseases, Iasi, Romania.
Fatma AmerDepartment of Medical Microbiology and Immunology, Zagazig University, Faculty of Medicine, Zagazig, Egypt.
Serkan OncuDepartment of Infectious Diseases and Clinical Microbiology, Adnan Menderes University, School of Medicine, Aydin, Türkiye.
Imran HasanogluDepartment of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Türkiye.
Ahmed Ashraf WegdanDepartment of Medical Microbiology and Immunology, Fayoum University, Faculty of Medicine, Fayoum, Egypt.
Fatma EserDepartment of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Türkiye.
Hatice Rahmet GunerDepartment of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Türkiye.
Ayse Kaya KalemDepartment of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Türkiye.
Federica CosentinoDepartment of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy.
Entela KolovaniUniversity Hospital Center "Mother Theresa," Infectious Disease Clinic, Tirana, Albania.
Alper TahmazDepartment of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Türkiye.
Meliha Cagla SonmezerDepartment of Infectious Diseases and Clinical Microbiology, Hacettepe School of Medicine, Hacettepe University, Ankara, Türkiye.
Jurica ArapovicInfectious Diseases Department, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
Mehmet Resat CeylanDepartment of Infectious Diseases and Clinical Microbiology, Harran University, School of Medicine, Sanliurfa, Türkiye.
Bircan KayaaslanDepartment of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Türkiye.
Atousa HakamifardInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Taylan ÖnderDepartment of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University, School of Medicine, Canakkale, Türkiye.
Gulden Eser-KarlidagDepartment of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazig Fethi Sekin City Hospital, Elazig Türkiye.
Hamed Azhdari TehraniDepartment of Hematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Syam Kumar AddepalliDepartment of Microbiology, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India.
Hema Prakash KumariDepartment of Microbiology, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India.
Meela Ranjith KumarDepartment of Pharmacology, Government Medical College & Government General Hospital, Suryapet, Telangana, India.
Suresh Babu SayanaDepartment of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India.
Oguz Resat SipahiInfectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Herein, we aimed to analyze the final diagnosis in a well-defined cohort of fever of unknown origin (FUO) cases whose erythrocyte sedimentation rate (ESR) was 100 mm/h or more during the admission. The subgroup of the FUO patients with an ESR of 100 mm/h or more during the FUO evaluation, was extracted from the study database of a previously published multicenter study (European Journal of Clinical Microbiology & Infectious Diseases. April 15, 2023;42 (4):387-98). Data for 139 patients (17.6%, 139/788 of the original cohort) who fulfilled the study inclusion criteria, were obtained from 29 centers from 11 countries. Infections, neoplasms, and noninfectious inflammatory diseases were found to be the reason of fever in [n = 74 (53.2%)], [n = 14 (10%)], and [n = 13 (9.3%)] of 139 patients, respectively. Regardless of the diseases subgroup top 6 diseases that were determined to be the reasons of FUO were tuberculosis [n = 15 (10.8%)], HIV/AIDS [n = 13 (9.3%)], urinary tract infection [n = 9 (6.5%)], infective endocarditis [n = 9 (6.5%)], lymphoma [n = 9 (6.5%)], and abscess [n = 9 (6.5%)]. The most common infectious diseases were tuberculosis (15/74, 20.2%), HIV/AIDS (13/74, 17.5%), and infective endocarditis (9/74, 12.1%), along with urinary tract infection [n = 9 (6.5%)] and abscess [n = 9 (6.5%)]. The most common noninfectious inflammatory diseases were adult onset Still disease (3/13, 23%) and giant cell arteritis, also known as temporal arteritis (3/13, 23%), and followed by polyarteritis nodosa (2/13, 15.3%). The most common neoplasm was lymphoma (9/14, 64.2%), followed by lung cancer (2/14, 14.2%). Reason of fever could not be defined in (29/139, 20.8%) patients. The invasive procedures were performed in (64/139, 46%) patients. Gender, age > 50 or not, and income level (high-middle-low) of the participating country were not associated with a significant difference in the final diagnosis category of the FUO case (P > .05). To the best of our knowledge, this is the first study evaluating the FUO in the subgroup of cases with extreme ESR elevation and infectious diseases comprised the most cause of the FUO in this particular subgroup.

Indexed as

Blood SedimentationFever of Unknown OriginAdultAgedCommunicable DiseasesFemaleHumansMaleMiddle AgedNeoplasmsRetrospective Studieserythrocyte sedimentation rateextremely high ESRPUOpyrexia of unknown origin

Identifiers

PMID40696644
PMCPMC12282769

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.