| Object:Discussing the etiology,clinical manifestations and laboratory indicators of fever of unknown origin(FUO)in children,In order to offer evidence for clinical work.Methods:From January 2015 to June 2018,the cases of children admitted to the second hospital of hebei medical university with FUO and meeting the diagnostic criteria were divided into 3 groups :<3 years old,3~7 years old,and >7 years old,and they were analyzed separately and retrospectively.Results:(1)A total of 493 cases were gathered,among which 443 cases(89.9%)were confirmed infectious diseases 349 cases(70.8%),52 cases(10.5%)of connective tissue diseases,16 cases(3.2%)of malignant tumors,26 children(5.3%)of ungrouped diseases,and 50 children(10.1%)of unidentified diseases.(1)In group 1,a total of 125 cases,including 103 cases of infectious diseases(82.3%),4 children of connective tissue disease(3.2%),4 children of malignant tumors(3.2%),and Ungrouped diseases in 5 cases(4%),Unidentified diseases in 9 cases(7.2%).(2)Children aged 3~7 years were 124 cases,including 82 cases of infectious diseases(66.1%),16 patients of connective tissue diseases(12.9%),5 children of malignant tumors(4.0%),6 children of other diseases(4.8%),and 15 children of Unidentified diseases(12%).(3)There were 244 children in group 3,including 164 children of infectious diseases(67.2%),32 children of connective tissue diseases(13.1%),7 children of cancer(2.9%),15 children of others(5.1%),and 26 cases of unclear diseases(10.7%).Also,the imparity of etiological composition between Infant group and preschool age,and they were obvious dissimilarity,but there was no significant difference between 3~7 years old group and >7 years old group.(2)Among the 349 children of infectious diseases,204 children(58.5%)had fever course of <4 weeks,89 cases(25.5%)had fever course of 4~8 weeks,and 56 cases(16%)had fever course of >8 weeks.Fever course in 52 cases of connective tissue disease in <4 weeks of 16 children(30.8%),4~8 weeks of 30 children(57.7%),and >8 weeks of 6 children(11.5%);Among the 16 children of cancer,5 children(31.3%)had fever course of <4 weeks,7 children(43.8%)of 4-8 weeks,and 4 children(25%)of >8 weeks.The difference between infectious disease and connective tissue disease was significant.(3)Among the 265 cases of infectious diseases examined,79 cases(29.7%)had rapid ESR,among which 20 cases(7.5%)had mild ESR,28 cases(10.5%)had moderate ESR,and 31 cases(11.7%)had severe ESR.Among the 54 cases of connective tissue diseases examined,43 cases(79.6%)had rapid ESR,including 3 children(5.6%)with mild ESR,14 children(25.9%)with moderate ESR,and 26 cases(48.1%)with severe ESR.The difference of the rate of ESR increase between the two groups was significant.(4)a total of 373 cases were tested for ESR and CRP,including 260 cases of infectious diseases,71 cases of ESR and CRP increased(27.3%),14 children of ESR increased(5.4%),37 children of CRP increased(14.2%),and 138 children of normal disease(53.1%).Among 51 cases of connective tissue disease,32 cases(62.7%)had increased ESR and CRP,9 cases(17.6%)had accelerated ESR,4 children(7.8%)had increased CRP,and 6 children(11.8%)had normal ESR.There were 8 children of malignant tumors,6 children(75%)with accelerated ESR and CRP,2 children(25%)with normal tumor,and 0 children with increased ESR and CRP.There were significantly more patients with connective tissue disease ESR and CRP than those with infectious disease,and the difference was significant.(5)The CRP of infectious diseases and connective tissue diseases were 16.8±30.9mg/L and 30.1±30.9mg/L,respectively,and the t-test value of the two was-2.3,P=0.03,the difference was statistically significant.The ESR of infectious diseases and connective tissue diseases were 19.9±22.7mm/h and 56.9±27.9mm/h,respectively.The t-test value of the two was-6.9,P=0.00,and the difference was significant.Conclusion:(1)The main causes of FUO in children at all ages were infectious disease,connective tissue disease,and cancer.(2)There are significant differences in composition: the ratio of infectious diseases in preschool and school-age children was significantly lower than with in infants,but the ratio of connective tissue diseases was significantly higher.(3)Connective tissue disease is more likely to occur as the fever course prolongs.(4)The higher the rate of ESR,the higher the possibility of connective tissue disease than infectious disease;Patients with increased ESR and CRP were more likely to have connective tissue disease;The levels of connective tissue disease CRP and ESR were higher than those of infectious diseases. |
PDF Full Text Request