A Analysis On Etiological Distribution And Clinical Features About Fever Of Unknown Origin

Objective:To investigate the etiology distribution,clinical characteristics and variation tendency of FUO,and to summarize the regularity,in order to provide envidence for clinical diagnosis of FUO.Methods:Clinical data of 286 FUO inpatients in the first affiliate hospital of Nanchang University from January 1,2016 to December 31,2018,including the diagnosis,gender,age,thermal processes,diagnostic method,clinical characteristic and laboratory result were analyzed retrospectively.Results:248 cases among the overall 286 FUO patients(86.7%)were eventually diagnosed.Including the infectious diseases[(n=191,66.8%;e.g bacterial infection 62.3%(119/191)];Connective tissue diseases(CTD)[(n=24,8.4%;e.g the adult still disease 62.5%(15/24)];neoplasms [(n=18,6.3%;e.g lymphoma 55.6%(10/18)];miscellaneous causes(n=15,5.2%),reason unknown(n=38,13.3%).The infectious diseases were the major cause of FUO in different periods,and the proportion of neoplasms from 2016 to 2018 was significantly lower than that from 2011 to 2013 patients(8.4% vs 13.2%,P=0.003).As for the causes of fever,164(57.3%)were male and 122(42.7%)were female,and the male to female ratio was 1.34:1.The distribution of FUO etiologies was no significant difference in different gender groups(P>0.05).The average age of FUO was 51.0 years(14-88 years old).The infectious diseases were the main cause in all age groups,of which the proportion was increased gradually with age.The distribution of FUO etiologies was no significant difference in different age groups(P>0.05).Of the 286 patients,142(49.6%)had a fever history of less than 1 month,114(39.9%)cases had a fever history of 1-3 months,and 30(10.5%)cases had a fever history of more than 3 months.There was a statistically significant difference in the etiology between the 1-3 months group and the more than 3 months group(P<0.05).In the diagnosis methods of 248 diagnosed FUO cases,the clinical diagnosis the imaging examination 20.2%,the pathological examination 17.7%,the diagnostic treatment 16.1%,and the laboratory examination 10.5%.There were statistical differences in the diagnostic methods between connective tissue disease and infectious disease,connective tissue disease and neoplasms,connective tissue diseases and miscellaneous diseases,as well as infectious diseases and miscellaneous diseases(P<0.05).Lymph node enlargement and rash were common in all kinds of unexplained fever diseases,14.0% patients have lymph node enlargement and 13.6% patients have rash.The clinical features as in rash,joint pain and lymph node enlargement were significantly differed in connective tissue disease between infectious diseases and other causes of diseases(P<0.05).PCT,CRP and WBC were significantly higher in infectious diseases than non-infectious diseases(P<0.05).ConclusionsThis research shows that infectious diseases remains the major cause of FUO,and the etiology of FUO varies from time to time.The diagnosis of the FUO etiologies has certain reference value in diagnosed,gender,age,thermal process and clinical characteristics.Pathology examinations such as bone marrow puncture and node biopsy play an important role for etiology.PCT,CRT and WBC also show great value in the diagnosis of infectious diseases.