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盗汗的诊断

Diagnosing night sweats.

作者信息

Viera Anthon J, Bond Michael M, Yates Scott W

机构信息

Family Practice Department, Naval Hospital Jacksonville, Jacksonville, Florida 32214-5005, USA.

出版信息

Am Fam Physician. 2003 Mar 1;67(5):1019-24.

Abstract

Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain important diagnostic considerations in patients with night sweats, other diagnoses to consider include human immunodeficiency virus, gastroesophageal reflux disease, obstructive sleep apnea, hyperthyroidism, hypoglycemia, and several less common diseases. Antihypertensives, antipyretics, other medications, and drugs of abuse such as alcohol and heroin may cause night sweats. Serious causes of night sweats can be excluded with a thorough history, physical examination, and directed laboratory and radiographic studies. If a history and physical do not reveal a possible diagnosis, physicians should consider a purified protein derivative, complete blood count, human immunodeficiency virus test, thyroid-stimulating hormone test, erythrocyte sedimentation rate evaluation, chest radiograph, and possibly chest and abdominal computed tomographic scans and bone marrow biopsy.

摘要

盗汗是门诊常见的主诉,但关于该主题的文献却很匮乏。结核病和淋巴瘤是盗汗为主要症状的疾病,但在现代临床实践中,很少发现它们是盗汗的病因。虽然这些疾病仍是盗汗患者重要的诊断考虑因素,但其他需要考虑的诊断包括人类免疫缺陷病毒、胃食管反流病、阻塞性睡眠呼吸暂停、甲状腺功能亢进、低血糖以及几种不太常见的疾病。抗高血压药、退烧药、其他药物以及酒精和海洛因等滥用药物可能导致盗汗。通过全面的病史、体格检查以及针对性的实验室和影像学检查,可以排除盗汗的严重病因。如果病史和体格检查未揭示可能的诊断,医生应考虑进行结核菌素试验、全血细胞计数、人类免疫缺陷病毒检测、促甲状腺激素检测、红细胞沉降率评估、胸部X光检查,可能还需要进行胸部和腹部计算机断层扫描以及骨髓活检。

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