P ROTRACTED fever occasionally presents a diagnostic problem not resolved by multiple laboratory and roentgenographic examinations or superficial biopsies. Although thorough non-operative evaluation is necessary, long-term observation with repeated laboratory studies is costly and may delay definitive therapy. Diagnostic laparotomy has been utilized in these patients but its value has been questioned.1,2 A review of 46 patients in whom laparotomy was performed for unexplained fever at the University Hospital suggests that if the criteria for surgery are well defined the diagnostic accuracy will be high and morbidity low.
Over the ten-year period ending July 1, 1963, laparotomy was performed in 46 patients to determine the cause of fever. Thtese patients all met the criteria set forth by Sheon and Van Ommen3 in that the temperature exceeded 100.5 F (38 C) orally, lasted longer than three weeks, and was unexplained after careful history, physical examination, complete blood count,
KELLER JW, WILLIAMS RD. Laparotomy for Unexplained Fever. Arch Surg. 1965;90(4):494–498. doi:10.1001/archsurg.1965.01320100038007