Utility Of A Simple Scoring System In Differentiating Bacterial Infections In Cases Of Fever Of Unkn

The leading cause of fever of unknown origin (FUO) is usually infectious disease, and serum inflammatory markers historically used to diagnose bacterial infection exhibit acceptable diagnostic sensitivity, their specificity remains low, so researchers sought to develop a simple scoring system for distinguishing bacterial infections from other causes of early-stage FUO. In this retrospective cohort study of patients presenting with FUO at the Huashan Hospital (January 2014 to June 2017), 34% of patients were identified to have bacterial infection. In the prospective cohort, bacterial infection was identified in 29% of cases. An AUC of 0.775 (95% CI, .695–.854) was generated by a model based on serum amyloid A (SAA) and serum ferritin (SF) levels and neutrophil percentage. Those with a score < 16.5 points, a lower probability (< 15%) of bacterial infection was suggested in validation analysis. Findings overall suggest the utility of a scoring system based on SAA and SF levels and neutrophil percentage in differentiating bacterial infection from other causes of FUO, potentially reducing antibiotic use.

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