State-of-the-Art Review: Contemporary Ambulatory Approach to Adult Fever of Unknown Origin
Wright WF, Betrains A, Schönau V, Mulders-Manders CM, Auwaerter PG, Rovers CP, Vanderschueren S (2026)
Publication Type: Journal article, Review article
Publication year: 2026
Journal
Book Volume: 82
Pages Range: 909-926
Journal Issue: 6
DOI: 10.1093/cid/ciag158
Abstract
Fever of unknown origin remains a diagnostic frontier, with research predominantly focused on the underlying disease spectrum. However, this focus largely overlooked issues between previous diagnostic criteria—the “quantitative” or “qualitative” definitions—and the critical role of evaluating the patient. This review synthesizes mounting evidence that the qualitative criteria are a central, yet underappreciated, driver of an effective and efficient clinical evaluation process for the ambulatory adult immunocompetent population. With input from infectious disease physicians, rheumatologists, and oncologists with expertise in this area, we chart the complex landscape of this widely recognized and potentially devastating condition, revealing key recommendations from a modified Delphi consensus panel and the Society of Nuclear Medicine and Molecular Imaging that offer changes beyond earlier definitions and management. By recentering the conversation around this updated approach, we argue for a paradigm shift for modern clinical practice and future research.
Authors with CRIS profile
Involved external institutions
Johns Hopkins Hospital
United States (USA) (US)
University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven
Belgium (BE)
Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC)
Netherlands (NL)
United States (USA) (US)
University Hospital Leuven (UZ) / Universitaire ziekenhuizen Leuven
Belgium (BE)
Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC)
Netherlands (NL)
How to cite
APA:
Wright, W.F., Betrains, A., Schönau, V., Mulders-Manders, C.M., Auwaerter, P.G., Rovers, C.P., & Vanderschueren, S. (2026). State-of-the-Art Review: Contemporary Ambulatory Approach to Adult Fever of Unknown Origin. Clinical Infectious Diseases, 82(6), 909-926. https://doi.org/10.1093/cid/ciag158
MLA:
Wright, William F., et al. "State-of-the-Art Review: Contemporary Ambulatory Approach to Adult Fever of Unknown Origin." Clinical Infectious Diseases 82.6 (2026): 909-926.
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