CAUSES OF ACUTE UNDIFFERENTIATED FEVER IN EMERGENCY DEPARTMENT PATIENTS AT A TERTIARY HOSPITAL

Abstract

Background: Acute undifferentiated fever (AUF) is common in the emergency department, particularly in tropical countries, where a variety of infectious causes can be mixed. Early detection and diagnosis is essential to avoid complications, morbidity and mortality.

Objective: To find out the etiology, clinical characteristics and prognosis of patients who presented with acute undifferentiated fever to the emergency department of a tertiary care hospital in Karachi, Pakistan.

Methods: This was a cross sectional observational study carried out Medicine Department, Saidu Group of Teaching Hospital for six months March, 2025 to August, 2025. 250 patients with fever ≤ 14 days without a localizing source were enrolled. History, clinical examination and laboratory investigations were conducted which included complete blood count, liver function tests, renal function tests, blood culture, malaria smears, dengue serology and pathogen-specific tests. Demographic pattern, clinical features, laboratory abnormalities, etiology and outcome were analyzed.

Results: The mean age was 32.4 ± 18.7 years, with 58% males. The most common etiologies were Dengue (32%), Malaria (18%), Scrub Typhus (15%) and Typhoid (10%). Thirty eight percent had thrombocytopenia, 25 percent leukopenia, and 30 percent elevated liver enzymes. Multi-organ involvement was seen in 12% of the patients and overall mortality was 2%. Seasonal trends revealed that the presentation was higher during summer and monsoon months.

Conclusions: AUF is a major cause of morbidity in emergencies. Prompt diagnosis and management relies on early clinical evaluation, appropriate laboratory testing and knowledge of local epidemiology. A knowledge of common etiologies like dengue, malaria and scrub typhus can help guide appropriate therapy, minimize complications and improve patient outcomes in tertiary care centers.