Fever of Unknown Origin and Its Alterations in Past 15 Years / 中华医院感染学杂志

ABSTRACT

OBJECTIVE To investigate the changes in etiological factors and the diagnostic methods of fever of unknown origin(FUO).METHODS The clinical data were retrospectively studied from patients with FUO hospitalized in Tongji Hospital from Jan 1992 to Dec 2006.During this time,528 cases fulfilled the criteria of FUO.RESULTS Out of the 528 FUO cases,definite diagnosis was eventually achieved in 476 patients(90.2%).The most common causes of FUO were infectious diseases(54.9%),with tuberculosis accounting for 39.0%(113/290) of cases of infection.Seventy patients(13.3%) were suffered from malignancy;61 patients(11.6%) were suffered from connective tissue disease(CTD);and 55 patients(10.4%) were suffered from other diseases.However,no definite diagnosis had been made in the remaining 52(9.8%) cases until they discharged from the hospital.Pathological diagnosis(30.5%) was the most important diagnostic method,in addition constituent ratio of pathogenic microorganism detection,molecular biology identification technique,immunologic test,diagnostic therapy and imaging accounting for 21.6%,12.8%,12.2%,11.6% and 11.3%,respectively.CONCLUSIONS The causes and diagnostic method of FUO are altered in the past 15 years.Infectious diseases are still the most common cause of FUO,from which tuberculosis is the top one.The cases of fungal infection and AIDS are increased slowly.Malignancy is decreased and occupies the third place of FUO after rheu-matic diseases.Drug induced fever,various kinds of clinical symptoms and syndromes and multifactorial fevers are increased.Diagnostic methods and rate of definite diagnosis are improved.