Armstrong W S, Katz J T, Kazanjian P H
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0378, USA.
Clin Infect Dis. 1999 Feb;28(2):341-5. doi: 10.1086/515138.
To characterize the clinical features of human immunodeficiency virus (HIV)-associated fever of unknown origin (FUO) in the United States, we performed a retrospective analysis of cases that fulfilled specific criteria (published by Durack and Street in 1991) at two medical centers in the United States between 1992 and 1997. Seventy cases met criteria for HIV-associated FUO; the mean CD4 cell count was 58/mm3, and the mean duration of fever was 42 days. A cause of FUO was found in 56 of the 70 cases; 43 were of a single etiology, and in 13 cases multiple conditions were established. The most common diagnoses were disseminated Mycobacterium avium infection (DMAC; 31%), Pneumocystis carinii pneumonia (13%), cytomegalovirus infection (11%), disseminated histoplasmosis (7%), and lymphoma (7%). In this United States series, FUO occurs most often in the late stage of HIV infection, individual cases often have multiple etiologies, and DMAC is the most common diagnosis.
为了描述美国人类免疫缺陷病毒（HIV）相关不明原因发热（FUO）的临床特征，我们对1992年至1997年间在美国两个医疗中心符合特定标准（由杜拉克和斯特里特于1991年公布）的病例进行了回顾性分析。70例病例符合HIV相关FUO标准；CD4细胞计数平均值为58/mm³，发热平均持续时间为42天。70例病例中有56例找到了FUO的病因；43例为单一病因，13例确定为多种情况。最常见的诊断为播散性鸟分枝杆菌感染（DMAC；31%）、卡氏肺孢子虫肺炎（13%）、巨细胞病毒感染（11%）、播散性组织胞浆菌病（7%）和淋巴瘤（7%）。在美国的这个系列研究中，FUO最常发生在HIV感染晚期，个别病例往往有多种病因，且DMAC是最常见的诊断。
