Analysis of the etiology and the clinical characteristic of fever in older patients / 中国实用内科杂志

ABSTRACT

Objective To analyze the etiology and the clinical characteristis of fever in older patients in Wenzhou.Methods Totolly 87 cases admitted to the First Affiliated Hospital of Wenzhou Medical College from January 2001 to April 2004 were retrospectively analyzed;all cases displayed fever as the major clinical manifestation and met the criteria of fever well.Results The etiology of fever which was infectious disease was in 44 of the 87 cases,accounting for 50.6%,collagen-vascular diseases 4.6%,neoplasms 10.3% and miscellaneous diseases 5.7%.In 28.7% of the cases the etiology could not be found.And in the infectious disease the tuberculosis accounted for 13.6%(6/44). Ultrasonography ,X-rays,CT scan,MRI,the marrow puncture and biopsy contributed to the final diagnosis in 21.1%,16.9%,63%,0,16.7% and 57.1% of the cases,respectively.Conclusion Because the symptoms of the older patients'febrile diseases are atypical,the diagnosis is more difficult.Infectious disease still remains a major cause of the fever in the elderly.A thorough history of disease,full physical examination of the patient and routine laboratory studies,especially erythrocyte sedimentation rate,are very important in determining the etiology of febrile disease.Early and reasonable use of non-invasive imaging techniques and the essential invasive methods are helpful to diagnosis.