Clinical Analysis Of84Cases For Fever Of Unknown In Respiratory Ward

Background and Objective: FUO （fever of unknown origin）is acommon disease on our clinical work. Petersdorf and Beeson first define it andit has four traits: Firstly, the fever does not have a clear incentive; Secondly, itlasts more than three weeks; thirdly, the body’s temperature is higher than38.3centigrade degrees centigrade; fourthly, it can’t be diagnosed within one weekafter the patients have been enquired explicitly about their medical history,been taken routine laboratory tests and taken physical examination. Thediagnosis standard doesn’t include the fever of unknown that cured inshort-term, some certain self-limiting viral infection and functional fever. It isreported that there are more than200kinds of diseases that can lead to fever ofunknown in our country. FUO involves multi-wards, multi-system diseases.Following factors make the FUO disease spread slowly and difficult to bediagnosed：the clinical manifestations of many diseases are not typical orsimilar; some of them lacks of symptoms and signs; the patients factors;medical and technical factors. Those always are major problems that interfereclinicians. Fever of unknown origin is divided into four categories in ourclinical work: infective diseases, connective tissue and inflammatory vasculardiseases, malignant tumor diseases and the other diseases. Someone reportedthat nearly10%of FUO patients with prolonged fever can not be diagnosedafter times investigation. Doctor’s clinical experience plays a very importantrole on the diagnosis and treatment of FUO. There exists a certain regularityabout the diagnosis and treatment of FUO. In order to improve the accuracy ofdiagnosis of FUO, investigate the regularity, summarize experience, we make the report on clinical analysis for84cases of fever of unknown through theproportion and their characteristics in four major categories of diseases, andanalysis the FUO with the same or similar clinical symptoms or signs of FUOof common diseases to summary the experience and therapeutic experience andto guide clinical diagnosis and treatment.Methods：We have chosen84cases of FUO in patients in the Departmentof Respiratory Medicine in the Chinese-Japanese Friendship Hospital of JilinUniversity from March2009to September2010. The patients are divided intofour groups: infective diseases; connective tissue and inflammatory vasculardiseases; malignant tumor diseases and the other diseases. According to the age,gender, disease duration, diagnostic methods, each type of disease is grouped,then we make the statistics of its incidence and diagnostic methods, summarizethe regularity and analysis the similar diseases of FUO along with the samesymptoms or same signs.Results: After various examinations and specific treatment the definitediagnosis was finally made in76cases (90.47%). Among them,48cases(57.12%) were caused by infective diseases,14cases (16.66%) were sufferedfrom connective tissue and inflammatory vascular diseases,9cases (10.71%)were diagnosed as malignant tumor diseases,5cases (5.95%) of the FUO weredue to the other diseases and the last8cases (9.52%) was still unknown. InInfective diseases,14cases turned to be tuberculosis, accounting for29.16%;lung infection,8cases, accounting for16.67%. In connective tissue andinflammatory vascular diseases, adult onset still’s disease (AOSD) is up to atotal of four cases, accounting for28.57%. Malignant tumor diseases, includeshematological neoplasms and solid tumors, in which lymphoma in2cases(22.22%). Subacute thyroiditis (2/5) is the first etiology in five cases of theother diseases. The men are more than women in the proportion of84patients,but women make a larger proportion in the connective tissue and inflammatory vascular diseases. Among the different ages, infective diseases have the largestproportion. But connective tissue and inflammatory vascular diseases in the40-60age group is the second etiology, while malignant system diseases inpatients above60years of age group is the second etiology. Among thedifferent duration, infective diseases have the largest proportion. But in theduration of2-3months group, connective tissue and inflammatory vasculardiseases increases to the second etiology. While in the duration of more than3months group, malignant tumor diseases becomes the second etiology. Indifferent diagnostic methods, imageology test is the main method, performing32%，then is therapy method, performing23%Conclusion: Infective diseases is the main cause of FUO. Then isconnective tissue and inflammatory vascular diseases and malignant tumordiseases. Tuberculosis and lung infectious diseases are the two major etiologyin infective diseases. Adult onset still’s disease(AOSD)is the most frequentdisease in the connective tissue and inflammatory vascular diseases. Andmalignant diseases including hematological neoplasms and solid tumorsalso accounts for a certain percentage. Most of the FUO can be diagnosed bydetailed medical history, thorough examination and experimental treatmentwhen necessary.