Limper M, Gerstenbluth I, Duits A J, van Gorp E C M
Slotervaart Hospital, Department of Internal Medicine, Louwesweg 6, 1066 EC Amsterdam, The Netherlands.
West Indian Med J. 2012 Jan;61(1):76-80.
The aetiology of febrile diseases in tropical countries often remains poorly characterized. We aim to describe the aetiology and outcome of febrile illnesses at the Emergency Department (ED) in Curaçao.
From April 2008 - April 2009, all adult febrile patients (T> 38.5 degrees C) at the ED of the St Elisabeth Hospital, Curaçao, Netherlands Antilles, were included. Clinical data were recorded, routine laboratory measurements and blood cultures were taken. Final diagnoses were made at discharge by an independent physician and in retrospect by the main investigator
Four hundred and three patients were included: 223 patients (55.6%) were hospitalized, 32 patients (7.9%) died and 18 patients (4.5%) were admitted to the Intensive Care Unit. In 129 febrile patients (32.0%), infection was proven; 84.4% of patients had bacterial (29.0% urinary tract infection, 23.2% pneumonia infection), 5.6% viral and 10.0% parasitic or fungal infections. Twenty-one patients (5.2%) were discharged with a non-infectious diagnosis and 172 patients (42.7%) without a clear diagnosis.
A high mortality rate of 7.9% was observed. We found a high prevalence of bacterial infections, with pneumonia and urinary tract infections as the most common causes of fever. One in 20 patients did not have an infectious disease.
热带国家发热性疾病的病因通常仍未得到充分描述。我们旨在描述库拉索岛急诊科发热性疾病的病因及转归。
纳入2008年4月至2009年4月在荷属安的列斯群岛库拉索岛圣伊丽莎白医院急诊科就诊的所有成年发热患者（体温>38.5摄氏度）。记录临床数据，进行常规实验室检测并采集血培养样本。最终诊断由一名独立医生在出院时做出，主要研究者进行回顾性诊断。
共纳入403例患者：223例患者（55.6%）住院治疗，32例患者（7.9%）死亡，18例患者（4.5%）入住重症监护病房。129例发热患者（32.0%）确诊感染；84.4%的患者为细菌感染（29.0%为尿路感染，23.2%为肺炎感染），5.6%为病毒感染，10.0%为寄生虫或真菌感染。21例患者（5.2%）出院时诊断为非感染性疾病，172例患者（42.7%）未明确诊断。
观察到7.9%的高死亡率。我们发现细菌感染的患病率很高，肺炎和尿路感染是发热的最常见原因。每20例患者中就有1例没有感染性疾病。
