| Objective:The clinical characteristics of 335 cases of Fever of unknown origin(FUO)hospitalized in pediatrics of our hospital were retrospectively analyzed,and the etiology of FUO was explored through the characteristics,in order to improve the understanding of pediatric clinicians on FUO and improve the level of diagnosis and treatment.Methods:A total of 335 children who were hospitalized and diagnosed in the Department of Pediatrics,Affiliated Hospital of Youjiang Medical University For Nationalities from January 2019 to December 2022 and met the diagnostic criteria for FUO in children were selected.Age,gender,onset season,heat course,clinical manifestations and auxiliary examination data were comprehensively analyzed,and the etiology of FUO was determined according to clinical data and specific examination results.The correlation between clinical features and etiology was also discussed.Results:(1)Among the 335 children with FUO,there were 206 males(61.5%)and 129females(38.5%),with a male-female ratio of 1.60:1.The mean age was 55.79±50.43 months,ranging from 40 days to 14 years.There were 75 cases(22.4%)in the infant group,94 cases(28.1%)in the infant group,82 cases(24.4%)in the preschool group,and 84 cases(25.1%)in the school-age group.July and August are high incidence months.The heat duration ranges from 14 days to 68 days,with an average of 24.9 days.(2)Of 335 children with FUO,323(96.4%)had a definite cause.Among them,134 cases(41.5%)were confirmed by comprehensive clinical analysis,83 cases(25.7%)by specific laboratory examination,69 cases(21.3%)by imaging examination,and 37 cases(11.5%)by pathology examination.Another 12 cases(3.6%)were discharged with no clear cause.(3)Among the 323 children with FUO whose etiology was identified,247(76.5%)were infected,76(23.5%)were non-infected,39(51.3%)were rheumatic disease,30(39.5%)were neoplastic,and 7(9.2%)were other diseases.(4)Respiratory tract infection was the most common infectious disease in 247 cases of FUO,169 cases(68.4%).Kawasaki disease(59.0%)was the most common rheumatic disease in 39 cases of FUO.Among the 30 cases of FUO,leukemia was the most common disease in 16 cases(53.3%).(5)The pathogen detection rate of infectious disease FUO was 51.8%,with bacterial infection taking the first place,followed by mycoplasma,virus,parasite,tuberculosis and other infections.Bacterial infection was common in infants,mycoplasma infection was more common in preschool group,and parasitic infection was most common in school-age children.(6)The heat course of infectious diseases was less than 4 weeks,the heat course of rheumatic disease was more than 4 to 8 weeks,and the heat course of neoplastic diseases was more than 8 weeks.Accompanying symptoms and signs: the most common infectious diseases are lymph node enlargement;the most common rheumatic disease are arthralgia and rash;children with neoplastic diseases are often accompanied by hepatomegaly and splenomegaly.(7)By multivariate logistic regression analysis,CRP,ESR and SF were independent risk factors for non-infectious disease FUO.Conclusion:(1)The main causes of FUO in children were infectious diseases,among which respiratory tract infection was the most common cause.Rheumatic disease was the the second cause of FUO,Kawasaki disease is the most common.Neoplastic and other diseases are rare.(2)The pathogens of FUO infectious diseases are bacterial infection,followed by mycoplasma,virus,parasite,tuberculosis,etc.,and the composition of pathogens infected by different age groups is different.(3)Gender,age,heat course,clinical symptoms and signs have certain reference value for the etiological diagnosis of FUO.(4)Elevated CRP,ESR and SF were independent risk factors for non-infectious diseases of FUO. |
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