| Objective To understand and explore the clinical features, the diagnostic pathway and the etiological constitution of fever patients in the respiratory department, and to provide a valuable reference for the future clinical diagnosis and treatment.Methods All 443 cases of fever patients admitted to the First Affiliated Hospital of Anhui Medical University from January 1st 2014 to December 31 st 2014, were divided into two groups by diagnosis:infectious and non-infectious groups and meanwhile three groups were divided into <45 years old, 45~ 59 years old, and≥60 years old group according to age. Their clinical data were retrospectively analyzed according to the age distribution, fever characteristics, diagnostic methods and so on. The results of count and measurement data between groups were compared by chi square test and t test respectively.Results Of all 443 cases, 292 cases were male(65.92%), 151 cases were female(34.08%), aged from 14 to 90 years old, average 60.33±17.70 years before admission; Longest fever duration was one years, 10.05±27.61 days of an average fever duration; from 1 to 52 days in hospitalization, the average 13.22±8.61 days. Infectious diseases were identified in 321(72.5%) of 443 cases, including pneumonia in 168 patients(52.3%,168/321). Non-infectious diseases were diagnosed in 122 cases(27.5%,122/443), including lung cancers in 105(86.1%,105/122). According to age groups, 71 0f 80 cases in group 1(<45 years old) were defined as infectious diseases, including pneumonia in 40 cases(57.1%,40/71), acute tracheobronchitis in 12(16.9%,12/71) and tuberculous pleuritis in 10 cases(14.0%,10/71). 9 cases of the 80 cases had non-infectious disease with 7 cases lung cancer. 56 0f 93 cases in group 2(45-59 years old) were recognized as infectious diseases(60.2%,56/93) including pneumonia in 33 cases(58.9%,33/56), lung abscess and AECOPD all in 5 cases. 39 cases(41.9%,39/93)in group 2 were non-infectious disease, 35 of which were diagnosed as lung cancer(89.7%,35/39). 195 of 270(72.2%,195/270)cases in group 3(≥60 years old) were infectious disease, including pneumonia in 95(48.7%,95/195); AECOPD in 42(21.5%,42/195). 75 of the 270 cases(27.8%,75/270) in group 3 had non-infectious disease, including lung cancer in 63 cases(84.0%,63/75), anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitides in 8 cases(10.7%,8/75).The fever time of patients with infectious diseases before admission is short, mainly within two weeks.The level of CRP and blood routine in infectious disease group was significantly higher than that in non infectious disease group(t = 3.067;p = 0.002).142 cases(32.05%) was definitely diagnosed by the general clinical data, such as history, symptoms and signs, 150 cases(33.86%) by further chest CT examination, 60(13.54%) cases by cytology or pathology examination and 91(20.54%) cases was confirmed through clinical diagnostic treatment.Conclusions The main cause of fever patients in respiratory department of our hospital was infectious diseases, of which pneumonia cases had the greatest proportion. Accounting for the second cause of infectious diseases was acute bronchitis in less than 45 years old group and the occurrence of pulmonary abscess should be paid attention in 45 to 59 years old. The acute exacerbation of chronic obstructive pulmonary disease was accounted for the second part of infectious diseases in more than 60 years old. The feature of fever in infectious diseases was acute onset, the short fever duration with higher CRP and blood routine. Lung cancer was the most common cause of non-infectious diseases in all patients, which should be paid attention.The common diseases of fever patients may be definitely diagnosed through the general clinical data. Chest CT examination also plays an important role in differential diagnosis. Pathological examination still is the gold standard in diagnosis of lung cancer.And empiric therapy is an indispensable means in diagnosis of difficult cases. |
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