GASTROINTESTINAL DOCTOR
Pyrexia of Unknown Origin (PUO) and Its Relation to the Gastrointestinal System
Introduction
Pyrexia of Unknown Origin (PUO), commonly referred to as fever of unknown origin, is a challenging clinical condition characterized by a prolonged fever without an obvious cause despite thorough investigation. The gastrointestinal (GI) system plays a significant role in a variety of conditions that can present as PUO. Dr. Karan R Rawat, the best gastroenterologist and hepatologist in Agra, specializes in diagnosing and managing complex GI disorders, including those associated with PUO.
Understanding PUO
PUO is defined by the following criteria:
- Fever higher than 38.3°C (101°F) on multiple occasions
- Duration of fever for more than three weeks
- Inability to determine the cause of fever after one week of hospital evaluation
GI Conditions Associated with PUO
Several gastrointestinal and hepatobiliary conditions can present as PUO, including:
1. Infectious Causes
- Liver Abscess: Bacterial or amoebic liver abscesses are common causes of prolonged fever. Symptoms may include right upper abdominal pain, weight loss, and fatigue.
- Enteric Fever: Caused by Salmonella typhi or paratyphi, this condition often presents with sustained fever, abdominal discomfort, and hepatosplenomegaly.
- Tuberculosis (Abdominal TB): This form of TB can affect the peritoneum, lymph nodes, or intestines, leading to chronic fever, abdominal pain, and weight loss.
2. Inflammatory Conditions
- Inflammatory Bowel Disease (IBD): Crohn’s disease and ulcerative colitis may present with PUO, especially during flare-ups.
- Autoimmune Hepatitis: This condition involves immune-mediated liver inflammation and can manifest as prolonged fever.
3. Neoplastic Causes
- Gastrointestinal Malignancies: Cancers of the stomach, colon, or pancreas may present with fever of unknown origin, especially if metastasis or secondary infections are involved.
- Lymphoma: Abdominal lymphomas may cause persistent fever, night sweats, and weight loss.
4. Drug-Induced Fever
Certain medications used to treat GI conditions may lead to PUO as an adverse reaction. Identifying and discontinuing the offending drug is crucial.
Diagnostic Approach
Dr. Karan R Rawat emphasizes a structured approach to diagnosing PUO:
- Detailed Medical History: Assessment of travel history, drug use, and previous infections.
- Comprehensive Physical Examination: Identification of abdominal tenderness, organomegaly, or lymphadenopathy.
- Laboratory Investigations: Complete blood counts, liver function tests, blood cultures, and inflammatory markers.
- Imaging Studies: Ultrasound, CT scan, or MRI to detect abscesses, tumors, or lymph node enlargement.
- Endoscopic Procedures: Upper GI endoscopy and colonoscopy may be performed to identify underlying lesions or sources of infection.
Treatment Modalities
The treatment of PUO depends on the underlying cause:
- Infections: Antibiotics or antifungal medications are prescribed based on culture and sensitivity reports.
- Inflammatory Conditions: Corticosteroids and immunosuppressive agents may be used.
- Neoplasms: Surgical intervention, chemotherapy, or radiation therapy may be required.
- Supportive Care: Management of symptoms, including hydration and antipyretics.
Why Choose Dr. Karan R Rawat?
Dr. Karan R Rawat is a renowned gastroenterologist and hepatologist in Agra with extensive expertise in diagnosing and managing complex cases of PUO related to the gastrointestinal system. His patient-centric approach, advanced diagnostic skills, and comprehensive treatment plans make him the preferred choice for patients seeking expert care.
Conclusion
Pyrexia of Unknown Origin (PUO) is a complex medical condition often linked to gastrointestinal disorders. With the expertise of Dr. Karan R Rawat, patients in Agra and nearby regions receive accurate diagnoses and effective treatments for even the most challenging cases. If you or a loved one is struggling with unexplained fever, consult Dr. Karan R Rawat for the best gastroenterological care.
