Unexplained episodes of fever: An early manifestation of colorectal carcinoma

The possibility that fever may be an early manifestation of colorectal carcinoma was examined. Of 92 consecutive patients, 28 had preoperative fever. In four patients the fever was the presenting symptom of the colonic tumor, and in another six patients it preceded gastrointestinal complaints by 1 week to 4 months. Fever was thus the earliest manifestation of colorectal carcinoma in 10.8% of the patients. In 13 of the 28 patients the fever could not be explained by the intraoperative findings. We suggest that transient bacteremia may be a common but frequently overlooked manifestation of colonic cancer. Prognosis of the patient may be improved by alertness to the possibility that an episode of unexplained fever may be the first, and sometimes the only, manifestation of colorectal carcinoma.