Cardiac myxoma should be considered in the differential diagnosis of fever of unknown origin, which often presents with a median temperature of 38.9°C and takes several months to diagnose.
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Cardiac myxoma merits FUO consideration; Level 5 data leaves open prospective validation of diagnostic timelines.
Fever of unknown origin A cardiac myxoma is a rare causative disease of fever of unknown origin. A comprehensive collection of the pertinent lit-erature on cases of a cardiac myxoma presenting with fever of unknown origin until October 2016 resulted in 58 articles including 62 patients. The patients' temperature during hospitalization was 38.80.7C (range, 37.4C-40C; median, 38.9C) (Fig. The temperatures of the patients were in a normal distribution (Fig. The duration of fever (time interval from the onset of fever to presentation) was 6.414.6 months (range, 5 days-8 years; median, 2 months) (Fig. Laboratory findings may reveal leukocytosis, thrombocytosis or thrombocytopenia, anemia, and elevated erythrocyte sedimentation rate and C-reactive protein levels. In this patient setting, the time of diagnosis (time from the onset of fever to diagnosis) of a cardiac myxoma was 6.06.1 months (range, 0.5-24 months; median, 3.2 months) and that from presentation to diagnosis was 1.42.6 months (range, 0.07-10 months; median, 0.33 months). It is reasonable that the time from the onset of fever to diagnosis is equal to the time from onset to presentation plus the time from presentation to diagnosis. However, because of the lack of necessary data from the literature, the final statistics showed a smaller time interval from the onset of fever to diagnosis than that from the onset of fever to presentation.
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