Retrospective Analysis Of Clinical Characteristics Of Fever Of Unknown Origin

Objective:Fever of unknown origin(Fever of unknown origin, hereinafter referred to as FUO) is the disease defined as the process of fever is more than 2 to 3 weeks,temperature is equal or greater than 38.5 Degrees Celsius,and can't be diagnosed by exhaustive disease history, physical examination and routine laboratory tests concerning FUO. This syndrome relate to multi-disciplinary, such as respiratory medicine?hematology?rheumatology etc., the clinical manifestation is atypical, and lack of specific diagnosis methods; meanwhile, most primary-care physicians are specialists, it's difficult to systematically understand and grasp the cause of FUO,easy to false and missed diagnosis,because of the limited medical level and psychological factors in patients. All of these factors, leading to difficultly identify the cause of FUO , become a major problem which continuously troubles clinicians.Clinicians' thought of the diagnosis about FUO can directly affect the efficiency of the diagnosis and treatment referring to FUO, in order to improve the accuracy of FUO diagnosis and explore the improving methods of diagnosis and treatment model, this study used a retrospective analysis methods to analyze the distribution of pathogenesis?diagnostic methods?gender?age?thermal process?highest body tem perature?first visiting department of 88 patients with FUO, concluding clinical thought of FUO to guide the clinical diagnosis and treatment.Method:88 cases of hospitalized patients from Guangzhou Medicine University affiliated the first hospital between April 2016 and September 2016 were retrospect-tively analyzed Recorded 88 cases of patients' the distribution of pathogenesis?diagnostic methods?gender?age?thermal process?highest body temperature?first visiting department., used the software for chi-square?rank sum test statistical process with the method of SPSS 21 ( Statistical Product and Service Solutions,hereinafter referred to as SPSS ), it's significant for the results when probability less than or equal to 0.05.Results:1?Divided into groups by pathogenesis, 85 cases are finally diagnosed in 88 case of patients after the systematical check or diagnostic treatment, diagnostic rate was 96.5 percent, 41 cases are infectious diseases(accounting for 46.6 percent),26 cases are connective tissue diseases(accounting for 29.5 percent) , 12 cases are ma lignant tumor diseases(accounting for 13.6 percent), 6 cases are other diseases((accounting for 6.8 percent)and 3 cases((accounting for 3.4 percent) could not be confined until they were discharged from hospital. The most case in infectious diseases was tuberculosis, counting up to 12 cases(accounting for 29.3 percent) .In connective tissue diseases,the most case was adults' onset sill's disease(in total of 11 cases, accounting for 42.3 percent). The most case in malignant tumor diseases was lym phoma, counting up to 6 cases((accounting for 50 percent). Among o ther diseases, the most case was drug fever (in total of 2 cases, accounting for 33.3 percent).2?Divided into groups by diagnostic method, diagnostic treatment was the main method in FUO etiology diagnosis,accounting for 34.1 percent, followed by biopsy(20.5 percent).3?Divided into g roups by gender, in overall quantity, the male's number were slightly higher than the female's,the male to female ratio is equal among the infectious diseases, but the proportion of female was higher than the one of male in connective tissue disease, on the contrary, the female's proportion was lower than the male's in malignant tumor disease.4?Grouped by age group , infectious diseases accounted for high proportion in all age groups, and the proportion of infectious diseases in different age groups were equal. Connective tissue disease was the first cause in the age group of 41 to 60 years, malignnant tumor disease was the second cause in the age group of more than 60 years. 5?Grouped by fever process, infectious disease is the first cause in less than 2 months group, connective tissue disease is the first cause in 2 to 4 months group, malignant tumor is the f irst cause in more than 4 months group.6?Grouped by the highest body temperature, infectious disease?connective tissue disease were both the first cause in 38.5 to 38.9 degree centigrade group,malignant tumor disease was the first cause in 39.0 to 39.5 degree centigrade.7?Grouped by first visiting department, among the first visiting department of the FUO patients, p neumology department?emergency department was respectively the first choice?the second choice,the first visiting proportion of digestive system department?infectious department?endocrinology department fall far behind the one of pneumology department and emergency department.Conclusion:(1)Various diseases can result in FUO, and the cause of FUO are complex. 3.4 percent of all cases could not be finally confirmed in this study .(2)Infectious disease was the leading cause of FUO, pulmonary tuberculosis was primary cause of infectious, at the same time, pulmonary tuberculosis was also the first cause of FUO. Connective tissue disease?malignant tumor disease was respectively the second?the Third cause of FUO.(3)Among the diagnostic methods, the diagnostic treatment was the most available method, followed by biopsy?image examination?bacteriology?Immunology?body fluids and bone marrow puncture. There are laws to follow FUO, which can be c onfirmed according to a detailed history?careful physical examination?necessary auxiliary examination and diagnostic treatment..(4)FUO etiology distribution had certain degree of difference in different gender?a ge group?thermal process?the highest temperature?first visiting department and so on. In connective tissue diseases, the female's proportion was more than the m ale's,but the female's proportion was less than the male's in malignant tumor diseases. With the increasing age and extended thermal process, connective tissue disease and malignant tumor disease was becoming increasingly, but infectious disease was becoming descending. If the FUO patients have repeated high fever?prolonged thermal process and advanced age,it's nonnegligible for whom to firstly rule out the malignant tumor disease. The most FUO patients'firstly choiced department of first visiting was pneumology department?emergency department,which could draw a conclusion that most FUO patients ignored the significant role of connective tissue disease and malignant tumor disease in the pathogenesis of FUO,worthy for clinician to pay attention to do a good work in regard to pre-examination and triage, in order not to delay the state of illness.