Fever in Interstitial Lung Disease

Presentation of Hypersensitivity Pneumonitis and Idiopathic Pulmonary Fibrosis

IPF does not present with fever as a characteristic feature, and instead manifests with progressive dyspnea, cough, and restrictive physiology without systemic inflammatory symptoms 1
The American Thoracic Society recommends considering alternative diagnoses, including infection, malignancy, or other systemic conditions, in patients with interstitial lung disease and persistent fever for 15 days 2

Persistent fever for 15 days in a patient with interstitial lung disease findings should raise suspicion for infectious pneumonitis, drug-induced lung disease, connective tissue disease-associated ILD, organizing pneumonia, or malignancy 2
The American College of Chest Physicians suggests that the diagnostic workup should prioritize excluding infection and other systemic causes before attributing symptoms to HP or IPF 2
The American Thoracic Society recommends considering a multidisciplinary discussion if HP is still suspected despite prolonged fever, as the patient may have a superimposed infection or alternative diagnosis 3