Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci. 2020 Nov 9;35(43):e386. doi: 10.3346/jkms.2020.35.e386.
Characteristic fever patterns of malarial infection are clues for diagnosis. However, checking fever patterns in febrile patients has been usually missed, and unnecessary tests have been performed. We reviewed electrical medical record to check whether history-taking included questions on fever pattern in febrile patients. Main outcomes were time interval between visit and diagnosis of vivax malaria and proportion of patients who had taken unnecessary tests. Among 134 vivax malarial patients, asking about fever pattern was done in 64 (47.8%). Median time interval between visit and diagnosis was significantly shorter in patients whose fever pattern was asked than those not asked (3.2 hours vs. 18.6 hours; < 0.001). Unnecessary diagnostic tests were conducted in 27% (17/64) of patients asked about fever pattern and 71% (50/70) in patients not asked ( < 0.001). Proper history-taking can reduce time elapsed for diagnosis and performing unnecessary diagnostic tests in vivax malaria.
疟疾感染的特征性发热模式是诊断的线索。然而，发热患者的发热模式通常被忽视，导致不必要的检查。我们回顾了电子病历，以检查问诊中是否包含发热模式的问题。主要结局是就诊与间日疟诊断之间的时间间隔以及进行不必要检查的患者比例。在 134 例间日疟患者中，有 64 例（47.8%）询问了发热模式。询问发热模式的患者就诊与诊断之间的中位时间间隔明显短于未询问的患者（3.2 小时比 18.6 小时；<0.001）。询问发热模式的患者中有 27%（17/64）进行了不必要的诊断性检查，而未询问的患者中有 71%（50/70）进行了不必要的诊断性检查（<0.001）。正确的病史采集可以缩短间日疟诊断和进行不必要的诊断性检查所需的时间。
