| ObjectiveThe clinical data of 253 patients who met the diagnostic criteria of fever of unknown origin were summarized and analyzed.To clarify the etiology and clinical characteristics of FUO,in order to improve the level of diagnosis and treatment of the disease and to provide help for the clinical diagnosis and treatment in the future.Material and method1.Study object: 253 cases of FUO patients(male 138,female 115)met the FUO diagnostic criteria for inpatient treatment at Bethune First Hospital of Jilin Universityfrom January 2013 to December 2016.2.Diagnostic criteria:The frequency of fever was more than 38.3?,the duration of fever was longer than 3 weeks,and after at le ast one week of comprehensive examination in outpatient or inpatie nt system(including hospitalization in other hospitals),the diagnosis was still unclear.Comprehensive examination should include: blood routine,urine routine,stool routine ± occult blood,liver function,re nal function,electrolytes,blood culture,chest X-ray and abdominal B ultrasound.3.3.To summarize the etiology,clinical features,routine laborat ory and imaging examinations of 253 patients with FUO,analyze a nd compare the gender,age distribution,duration of disease,length of stay,cause of illness,and routine laboratory tests in different d isease groups.4.Statistical analysis:SPSS 22.0 software was used for statistical analysis.Measured data with normal distribution were expressed as mean± standard deviation((?)x±s).Comparisons between groups were performed using the Least-significant difference(LSD)method for analysis of variance.Chi-square test was used for count data,and statistical significance was significant at P<0.05.Result1.253 cases of FUO diagnosed and treated in our hospital from January 2013 to December 2016,30 cases(11.9%)of FUO were diagnosed and treated from January 2013 to December 2013,43cases(17.0%)from January 2014 to December 2014,71 cases(28.1%)from January 2015 to December 2015,and 109 cases(43.1%)from January 2016 to December 2016.2.Etiological classification:There were 220 cases of 253 FUO cases eventually diagnosed,which the diagnosis ratio was 87.0%.Including 123 cases of infectious diseases(48.6%),52 cases of rheumatic immunediseases(20.6%),37 cases of tumor diseases(14.6%),8 cases of fever of other diseases(3.2%),and 33 cases of unknown etiology(13.0%).3.Sex distribution: There were 79 male and 44 female patients with infectious diseases,34 female patients and 18 male patients with rheumatic immune diseases.23 cases were male patients and 14 cases were female patients with tumor diseases.Overall,there were more men than women in FUO patients,but more women than men in rheumatic immune diseases.4.Age distribution :The mean age of infectious disease group was45.59(±21.47)years old,that of rheumatic immune disease group was47.21(±17.91)years old,and that of tumor disease group was54.32(±15.94)years old.Tumor disease group has the largest average age.5.Course of disease :The course of disease was 66.68(±78.06)days in infectious disease group,61.17(±107.99)days in rheumatic immune disease group and 198.92(±602.65)days in tumor disease group.The longest course of disease in patients with tumor diseases.6.Length of stay:The hospitalization time of infectious disease group was 9.31(±5.86)days,that of rheumatic immune disease group was10.38(±5.36)days,and that of tumor disease group was 9.62(±6.46)days.Longest length of stay in patients with Rheumatological immune Diseases.7.Etiological distribution:Among 123 cases of infectious diseases,104 cases were infected with bacteria(84.6%),which was the main cause of infectious diseases,among which 46 cases(44.2%)of tuberculosis accounted for the highest proportion,and extrapulmonary tuberculosis was the most common.Of 52 cases of rheumatic immune diseases,22cases(42.3%)of adult still's disease were the most common.Among the37 cases of tumor diseases,21 cases(56.8%)were hematologic tumors,8cases(38.1%)were lymphoma.8.Etiological changes:The etiological composition of infectious diseases in FUO decreased from 53.5 percent in 2014 to 48.6 percent in2016,while that of rheumatic immune diseases in FUO increased from16.3 percent to 24.8 percent.There are statistical differences between infectious diseases and rheumatic immune diseases in the etiology of FUO in different years(P < 0.05).The etiological composition of tumor diseases in FUO declined from 26.7 percent in 2013 to 12.8 percent in2016.Infectious diseases and tumor diseases showed a downward trend in the etiology of FUO,while rheumatic immune diseases showed an increase.9.Laboratory results:There were 82 cases(32.4%)of leukocytosis,157 cases(62.1%)of rapid erythrocyte sedimentation rate,26 cases(10.3%)of elevated PCT and 148 cases(58.5%)of elevated C-reactive protein and 115 cases(45.5%)of ferritin on admission in 253 patientswith FUO.WBC count,erythrocyte sedimentation rate(ESR)and serum ferritin average were the highest in rheumatic immune disease group,and there were significant differences between groups(P<0.05).Conclusion1.The number of patients with FUO has increased year by year in recent years.2.Infectious diseases are still the most common cause in the classification of FUO etiology,of which tuberculosis infection is the main cause,especially extrapulmonary tuberculosis.3.Patients with rheumatic immune diseases are more common in female patients and stay in hospital for a long time,indicating that it is more difficult to diagnose rheumatic immune diseases.4.The course of disease is the longest and the average age is the largest in the patients with tumor diseases,which suggests that the onset of tumor diseases is relatively hidden,and the incidence rate of the elderly patients is the highest.5.In recent years,infectious diseases and tumor diseases have decreased in the etiological composition of FUO,and Rheumatic immune diseases increased.6.Laboratory tests such as WBC,PCT,erythrocyte sedimentation rate(ESR),CRP,ferritin and Imaging examination provide reference for the diagnosis of FUO. |
PDF Full Text Request