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特殊人群中的不明原因发热。

Fever of unknown origin in special groups.

作者信息

Santana Leonardo Fernandes E, Rodrigues Mateus de Sousa, Silva Marylice Pâmela de Araújo, Brito Rodrigo José Videres Cordeiro de, Nicacio Jandir Mendonça, Duarte Rita Marina Soares de Castro, Gomes Orlando Vieira

机构信息

. Discente de Medicina na Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, PE, Brasil.

. Médica formada pela UNIVASF, Petrolina, PE, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2019 Nov 7;65(10):1308-1313. doi: 10.1590/1806-9282.65.10.1308. eCollection 2019.

Abstract

Fever of undetermined origin (FUO) is a challenging entity with a striking presence in hospitals around the world. It is defined as temperature ≥ 37.8 ° C on several occasions, lasting ≥ three weeks, in the absence of diagnosis after three days of hospital investigation or 3 outpatient visits. The main etiologies are infectious, neoplastic, and non-infectious inflammatory diseases. The diagnosis is based on the detailed clinical history and physical examination of these patients, in order to direct the specific complementary tests to be performed in each case. The initial diagnostic approach of the FUO patient should include non-specific complementary exams. Empirical therapy is not recommended (with few exceptions) in patients with prolonged fever, as it may disguise and delay the diagnosis and conduct to treat the specific etiology. The prognosis encompasses mortality of 12-35%, varying according to the baseline etiology.

摘要

不明原因发热(FUO)是一个具有挑战性的病症,在世界各地的医院中都很常见。它被定义为在多次测量中体温≥37.8°C,持续≥三周,且在经过三天的住院检查或三次门诊就诊后仍未确诊。主要病因包括感染性、肿瘤性和非感染性炎症性疾病。诊断基于对这些患者的详细临床病史和体格检查,以便指导针对每个病例进行特定的辅助检查。FUO患者的初始诊断方法应包括非特异性辅助检查。对于长期发热的患者,不建议进行经验性治疗(少数例外情况除外),因为这可能掩盖并延迟诊断,并导致无法治疗特定病因。其预后包括12%至35%的死亡率,具体死亡率因基线病因而异。

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