发热待查75例临床分析

目的探讨不明原因发热(FUO)的病因和临床特征。方法回顾性分析2005年1月～2012年1月在我科住院且符合FUO诊断标准的75例患者的临床资料,总结了病因、诊断方法和临床表现。结果 75例患者中,68例(90.7%)最终确诊,感染性疾病22例(32.4%),其中结核病9例(40.9%)、传染性单核细胞增多症5例(22.7%);结缔组织病29例(42.6%),其中成人Still病17例(58.6%)、系统性红斑狼疮6例(20.7%);恶性肿瘤10例(14.7%),其中淋巴瘤6例(60.0%);其他疾病7例(10.3%),其中组织细胞坏死性淋巴结炎4例(57.1%)。结论 FUO涉及的病因众多,发病机制复杂,感染性疾病、结缔组织病仍是发热待查的主要原因,肿瘤性疾病在发热待查中也占相当的比例,临床工作中要开阔思路,全面搜集资料,以利于明确诊断。

Clinical features of 75 cases of fever of unknown origin

Objective To investigate the etiology and clinical features of fever of unknown origin(FUO).Methods A retrospective study was designed to analyse etiology,diagnostic methods and clinical features of 75 patients with FUO who were presented in our department from January 2005 to January 2012.Results Of these 75 FUO cases,a definitive diagnosis was reached in 68 cases(90.7%).Of them,22 cases(32.4%) were caused by infections,with tuberculosis accunting for 40.9%(9/22),infectious mononucleosis accunting for 22.7%(5/22).Twenty-nine patients(42.6%) were suffered from connective tissue diseases,with Adult-Onset Still,s disease accunting for 58.6%(17/29),systemic lupus erythematosus accunting for 20.7%(6/29).Ten cases(14.7%) were diagnosed as malignancy,with lymphoma accunting for 60.0%(6/10).Miscellaneous causes were found in 7 cases,with necrotizing lymphadenitis accunting for 57.1%(4/7).Conclusions The causes of FUO involve in numerous complex pathogenesis.The infectious diseases and connective tissue diseases are both significant causes.Malignant diseases are also important causes.We should broaden our idea and collect clinical dates to make diagnosis.