Abdominal pain and fever causes
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Common Infectious Causes of Abdominal Pain and Fever
Abdominal pain with fever is a frequent clinical presentation and can be caused by a wide range of conditions. Infectious diseases are among the most common causes. For example, dengue fever often presents with abdominal pain and fever, and the underlying causes in these cases can include acute hepatitis, acalculous cholecystitis, pancreatitis, peptic ulcer disease, appendicitis, spontaneous bacterial peritonitis, enteritis, and gastric erosions Khanna2005Kaur2022. Enteric fever (typhoid) is another infectious disease that can cause fever and abdominal pain, sometimes leading to rare complications like splenic infarcts . Febrile diarrheas, often of infectious origin, are also a common cause, with etiologies including microorganisms, toxins, and drugs .
Gastrointestinal and Hepatobiliary Disorders
Diseases of the gastrointestinal tract frequently cause both abdominal pain and fever. Inflammatory conditions such as inflammatory bowel disease (including Crohn’s disease and ulcerative colitis) can present with these symptoms, sometimes complicated by infection, perforation, or peritonitis Isaac2019Wysocki2015. Acute cholangitis, as seen in Lemmel’s syndrome, can also present with right upper quadrant pain, fever, and jaundice . Perforated Meckel’s diverticulum is another rare but important cause, especially in children, leading to peritonitis and systemic symptoms .
Autoinflammatory and Connective Tissue Diseases
Autoinflammatory diseases, such as Familial Mediterranean Fever (FMF), are important non-infectious causes of recurrent or acute abdominal pain with fever. These conditions are often misdiagnosed due to their rarity and require careful clinical assessment and sometimes genetic testing for confirmation Sinha2022Maconi2018. Connective tissue diseases, including Takayasu arteritis, can also present with fever and abdominal pain, particularly in children, and may require imaging for diagnosis .
Functional and Miscellaneous Causes
Functional abdominal pain disorders (FAPDs) are the most common cause of chronic abdominal pain, but they are diagnoses of exclusion and typically do not present with fever. However, other less common causes of abdominal pain and fever include infections like COVID-19 (PIMS-TS), Helicobacter pylori, and Yersinia species . Rarely, neoplasms or vascular events such as splenic infarcts may be responsible Üzüm2019Palaiyan2017.
Diagnostic Considerations
The basic mechanisms behind abdominal pain and fever include inflammation, infection, obstruction, ischemia, and, less commonly, hemorrhage or neoplasia . A thorough clinical evaluation, supported by laboratory tests and imaging, is essential to identify the underlying cause, especially since some conditions (like autoinflammatory diseases or Takayasu arteritis) may not be immediately apparent Üzüm2019Maconi2018.
Conclusion
Abdominal pain with fever can result from a wide spectrum of causes, including infections (such as dengue, enteric fever, and cholangitis), gastrointestinal and hepatobiliary diseases, autoinflammatory and connective tissue disorders, and, less commonly, neoplasms or vascular events. Accurate diagnosis relies on careful clinical assessment, appropriate laboratory investigations, and imaging studies to guide effective management and avoid misdiagnosis.
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