Febrile illness in adolescents and adults

Fever is one of the most common symptoms reported by patients seeking health care in low-resource areas in the tropics, where it may occur either in isolation or in association with other common symptoms such as cough or diarrhea (Feikin and others 2011; Prasad, Sharples, and others 2015). Fever without localizing features presents a particular challenge to health care workers and health systems because it may be caused by a wide range of bacterial, fungal, parasitic, and viral infections (Crump and others 2013; Mayxay and others 2013), as well as by noninfectious conditions. Clinical assessment has limited accuracy both for identifying the likely cause and for the early recognition of patients who will progress to serious or fatal disease. Compounding the limitations of clinical assessment is the dearth of available epidemiologic data on common causes of fever (Crump 2014) and absence of clinical laboratory services in many areas (Archibald and Reller 2001; Petti and others 2006)