Wei W, Hesheng L
Department of Internal Medicine, Renming Hospital, Wuhan University, HuBei, China.
Int J Clin Pract. 2003 Jul-Aug;57(6):508-12.
It is difficult to make a diagnosis when malignancy presents as fever of unknown origin (FUO). In order to update information on this disease entity, we performed a retrospective survey on adult cancer patients (n=48) presenting with FUO who were admitted to our university hospital between 1989 and 2002. All 48 patients had a median fever course of 56 days and a diagnostic phase of 13 days. Anaemia was found in 89.6% of the patients and elevated ESR in 77.1%. Of 35 patients (72.9%) with haematological malignancy, most were either lymphoma (n=18) or malignant histiocytosis (n=13). Solid tumours were found in 13 patients (27.1%), of which seven were hepatic carcinoma. Only five patients were correctly diagnosed, and 39 (90.7%) were mistaken for various infections. Inconclusive signs and symptoms, misinterpretation of test results and improper use of broad-spectrum antibiotics and corticosteroids all contributed to the misdiagnoses.
当恶性肿瘤表现为不明原因发热（FUO）时，很难做出诊断。为了更新关于这种疾病实体的信息，我们对1989年至2002年间入住我校医院的以FUO为表现的成年癌症患者（n = 48）进行了一项回顾性调查。所有48例患者的发热病程中位数为56天，诊断阶段为13天。89.6%的患者发现贫血，77.1%的患者血沉升高。在35例（72.9%）血液系统恶性肿瘤患者中，大多数是淋巴瘤（n = 18）或恶性组织细胞增多症（n = 13）。13例（27.1%）患者发现实体瘤，其中7例为肝癌。只有5例患者得到正确诊断，39例（90.7%）被误诊为各种感染。不确定的体征和症状、对检查结果的错误解读以及广谱抗生素和皮质类固醇的不当使用都导致了误诊。
