Crişan Alexandru, Nicoară Emilia, Laza Ruxandra
Clinica II Boli Infecţioase, Universitatea de Medicina si Farmacie Dr.V. Babeş Timişoara.
Pneumologia. 2009 Jan-Mar;58(1):24-6, 28.
Since the earliest days of systematic thermometry prolonged fever illness has fascinated and generated many frustrations to clinicians and laboratory physicians. The authors present peculiarities of 57 patients with prolonged fever illness that were admitted to 2nd Clinic of Infectious Diseases from "Dr.V.Babeş" Clinical Hospital of Infectious Diseases and Pneumo-phtisiology Timişoara between June 2006 and June 2008. We submit data about signs and symptoms associated with fever of unknown origin, dynamics of fever, different etiologies of prolonged fevers, underlying favourable host-associated conditions (immune deficiencies, comorbidities), importance of laboratory investigations and imaging studies in establishing etiologic diagnosis, duration of hospitalization, management of patients. 5% of cases of prolonged fever remained without etiologic diagnosis. Prolonged fever by its frequency, potential severity, multitude of etiologies that are involved, remains a diagnostic challenge and many times it imposes collaboration between different specialists. In our study percentage of infectious cause (73%) is much higher than in developed countries where prolonged fever of infectious origin represents only 27-33% of all cases, just a little above neoplasms. Today the percentage of cases without etiology is smaller because we have better access to more sophisticated diagnostic tools.
从系统体温测量开展的早期起,长期发热性疾病就一直吸引着临床医生和检验医生,同时也给他们带来了诸多困扰。本文作者介绍了2006年6月至2008年6月期间,在蒂米什瓦拉“V. 巴贝斯博士”传染病与肺痨临床医院第二传染病科收治的57例长期发热性疾病患者的特点。我们提供了与不明原因发热相关的体征和症状、发热动态、长期发热的不同病因、潜在的有利宿主相关状况(免疫缺陷、合并症)、实验室检查和影像学研究在病因诊断中的重要性、住院时间、患者管理等方面的数据。5%的长期发热病例仍未明确病因。长期发热因其发生频率、潜在严重性、涉及的病因众多,仍然是一个诊断难题,而且很多时候需要不同专科医生之间的协作。在我们的研究中,感染性病因的比例(73%)远高于发达国家,在发达国家,感染性长期发热仅占所有病例的27%-33%,略高于肿瘤病例。如今,无病因病例的比例较小,因为我们有更好的途径获得更先进的诊断工具。