What should be done if a fever persists for more than 7 days due to other causes?

When a fever persists for more than 7 days and is suspected to be due to causes other than common infections, assessing for tuberculosis is a critical step. Tuberculosis (TB) is a significant cause of prolonged fever, especially in certain populations or geographic areas where it is more prevalent. The disease can present with nonspecific symptoms, including a persistent fever, making it essential to rule it out in cases of protracted febrile illnesses.

This assessment may involve a thorough clinical evaluation, including a history of exposure, risk factors, and potentially diagnostic tests such as a tuberculin skin test or interferon-gamma release assays. In regions with a higher incidence of TB or among high-risk groups—such as those with a history of exposure to TB, immunosuppressed individuals, or malnourished children—failing to investigate TB could lead to significant morbidity or complications.

In contrast, although considering other possible viral infections, starting broad-spectrum antibiotics, or referring to a specialist may be relevant in different contexts, these approaches might not specifically target the underlying concern of prolonged fever due to tuberculosis. The need for a focused approach based on the clinical context justifies assessing for TB in this scenario.