关键词:

发热待查, 病因, 感染

Abstract:

Objective　To understand the characteristics of etiological distribution in 183 patients with fever of unknown origin (FUO), to compare the etiological composition of patients from different hospitals and age groups and with different genders and durations of fever, and to provide references for clinical diagnosis and treatment. Methods　The clinical data of 183 inpatients with FUO admitted to the departments of infectious diseases in Zhengzhou Sixth People's Hospital and First Hospital, Peking University from August 2022 to October 2023 were retrospectively analyzed. Based on the etiology, the patients were classified into infectious diseases (93 cases), non-infectious inflammatory diseases (NIID, 42 cases), neoplastic diseases (14 cases), other diseases (21 cases), and undiagnosed cases (13 cases). The differences in etiological distribution were compared between the patients from different hospitals and age groups and with different genders and durations of fever. χ² test was applied. Results　Among the patients, 61.20% (112/183) were male. They were (49.70±19.09) years old. The common confirmed causes in each group were bacterial infections, adult Still's disease, lymphoma, and necrotizing lymphadenitis. The proportions of infectious diseases in the patients in the two hospitals were 64.29% (27/42) and 46.81% (66/141), respectively, with a statistical difference (χ²=3.96; P<0.05). The proportion of infectious diseases in the patients who were 31-45 years old was higher than in that the patients who were 15-30 years old [63.89% (23/36) vs. 34.15% (14/41); χ²=6.79; P<0.05]. The proportion of other diseases in the patients who were 15-30 years old [29.27% (12/41)] was higher than those in the other groups (χ²=4.10, 6.35, and 9.51; all P<0.05). The proportion of NIID in the females was higher than that in the males [33.80% (24/71) vs. 16.07% (18/112); χ²=7.73; P<0.05]. The proportion of the infectious disease cases with a fever duration >3 months [12.50% (3/24)] was lower than those in the patients with fever durations <1 month and 1-3 months [61.33% (46/75) and 52.38% (44/84)] (χ²=15.45 and 10.51; both P<0.05). The proportion of the neoplastic diseases cases with a fever duration >3 months was higher than that in the patients with a fever duration <1 month [20.83% (5/24) vs. 4.00% (3/75); χ²=4.86; P<0.05]. The proportion of the undiagnosed cases with a fever duration >3 months was higher than that in the patients with a fever duration <1 month [16.67% (4/24) vs. 2.67% (2/75); χ²=4.04; P<0.05]. Conclusions　Clinicians should first consider infectious diseases when facing patients with FUO. The etiological composition of FUO may vary in different hospitals, age groups, and patients with different genders and fever durations. Therefore, precise and rapid relevant tests and examinations should be conducted based on the patients' clinical characteristics to clarify the causes as soon as possible.

Key words:

Fever of unknown origin, Causes, Infection