Clinical Etiology Analysis Of Patients With Fever Of Unknown Origin

Objective To analyze the etiology,diagnosis and clinical features of 288 patients with fever of unknown origin(FUO),provide reference for the diagnosis and treatment of FUO patients,and further improve the clinician's understanding and diagnosis rate of FUO.Methods To retrospectively analyze the medical records of 288 patients who were admitted to the Department of Infectious Diseases of the First Affiliated Hospital of Bengbu Medical College from October 2015 to April 2018,and who met the FUO diagnostic criteria,and analyzed the etiology and the distribution of the causes of FUO patients.Relationship with gender,age,and heat history.The data was analyzed using SPSS 25 statistical software.Result1.Etiology distribution 236 cases(81.9%)of the 288 patients with FUO were diagnosed,and 52 cases(18.1%)were still undiagnosed.The causes was classified as:Infectious Diseases(ID)146 cases(50.7%),of which lung infection accounted for23.3%(34/146),sepsis accounted for 20.5%(30/146),tuberculosis accounted for17.1%(25/ 146);Connective Tissue Diseases(CTD)36 cases(12.5%),including38.9%(14/36)of adult still diseases;22 cases(7.6%)of neoplastic diseases,31.8% of lymphomas(7/22);32 cases(11.1%)of other diseases,the most common drug fever was 56.2%(18/32).2.The method of diagnosis of serological or pathogenic examination is the most important method to determine the cause of FUO,93 cases(39.4%);the other is clinical or treatment response in 59 cases(25.0%);imaging examination in 54 cases(22.9)%);tissue biopsy in 30 cases(12.7%).3.Among the 288 patients with FUO collected by gender distribution,there were 140 males and 148 females;75 male infectious diseases,11 male connective tissue diseases,15 male tumor diseases,11 male other diseases,and undiagnosed males.There were 28 cases of female infectious diseases,27 cases of female connective tissue disease,7 cases of female tumor diseases,21 cases of female other diseases,and 24 cases of undiagnosed women.The proportion of CTD in female connective tissue disease was significantly higher than that in male.The proportion of male neoplastic disease was significantly higher than that in female,the difference was statistically significant(P<0.05).4.Age distribution In the case of definite diagnosis,infectious diseases are the primary cause in all ages,and are significantly higher than other groups of diseases,but more common in the 60-85 age group;CTD is 30-59 The age group was more common,and the neoplastic disease was more common in the 60-85-year-old group.The etiology of FUO was statistically significant in different age groups(?2=16.449,P=0.036).5.Heat history distribution Among 288 patients,177(61.4%)had a heat history ?1month,63 cases(21.9%)in 1-2 months,and 48 cases(16.7%)in February.Infectious diseases were the most common in all heat stroke groups,but the proportion of ?1month heat stroke group was the highest.With the extension of the heat course,the proportion of infectious diseases has decreased,and the proportion of non-infectious diseases has increased.There were significant differences in the etiology of FUO in different heat courses(?2=23.938,P=0.002).conclusion1.The most common cause of FUO is infectious diseases,followed by connective tissue diseases(CTD),other diseases,and neoplastic diseases.2.Infectious diseases are still the primary cause of FUO,among which the top three are lung infection,sepsis,and tuberculosis infection.3.In the diagnosis of FUO,serological or pathogenic examinations are ranked first,followed by clinical or therapeutic response,imaging examination,and tissue biopsy.4.There are some differences in the etiology of FUO patients between different genders,age groups and heat courses.FUO patients have detailed medical history,detailed physical examination,rational use of various diagnostic methods and diagnostic treatment,most patients can be diagnosed.