Grebenyuk Vyacheslav, Kryštůfková Olga, Gregová Monika, Sokalská-Jurkiewicz Magdalena, Steinbauerová Renata, Sukovská Marie, Gahérová Lubica, Zubatá Ivana, Gregorová Jana, Kaliská Lucia, Roháčová Hana, Trojánek Milan
Vnitr Lek. 2021 Winter;67(1):32-42.
Fever of unknown origin is a rare clinical syndrome, that represents a significant diagnostic challenge. There have been described more than 200 potential diseases, that can manifest as a fever of unknown origin. These are classically divided into following categories: infections, non-infectious inflammatory diseases, malignancies, and other miscellaneous disorders. Each of the disease type is associated with rather characteristic symptoms, clinical signs and laboratory findings, which are individually non-specific, but may provide helpful clues for a further focused diagnostic work-up. The clinicians task is to be able to identify these hallmark clinical features and to correctly interpret their significance and limitations in the appropriate differential diagnostic context. The aim of this review is to provide up-to-date clinical research evidence and to propose a concise clue-oriented diagnostic approach.
不明原因发热是一种罕见的临床综合征,是一项重大的诊断挑战。已描述的可表现为不明原因发热的潜在疾病超过200种。这些疾病通常分为以下几类:感染、非感染性炎症性疾病、恶性肿瘤和其他杂症。每种疾病类型都有相当典型的症状、临床体征和实验室检查结果,这些单独来看都不具有特异性,但可能为进一步的针对性诊断检查提供有用线索。临床医生的任务是能够识别这些标志性临床特征,并在适当的鉴别诊断背景下正确解释其意义和局限性。本综述的目的是提供最新的临床研究证据,并提出一种简洁的以线索为导向的诊断方法。