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以阑尾炎诊断的发热待查患者:1 例报告。

An FUO patient diagnosed as appendicitis: a case report.

机构信息

Department of Infectious Disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Pathology, Chongqing General Hospital, Chongqing, China.

出版信息

BMC Infect Dis. 2024 Sep 17;24(1):993. doi: 10.1186/s12879-024-09851-7.

Abstract

BACKGROUND

The diagnosis and management of fever of unknown origin pose significant challenges in the field of infectious diseases, as it is influenced by various factors. Infectious diseases have long been recognized as the primary etiology of fever of unknown origin. However, not all infectious diseases can definitively identify the causative pathogen and infection sites.

CASE PRESENTATION

we present a case report of an individual with fever, nausea, and anorexia but did not report any abdominal pain. Physical examination revealed no signs of abdominal tenderness. Repeated imaging studies including enhanced CT and color US of the appendix, only one color US suggested the possibility of appendicitis. Despite effective anti-infective treatment, the patient continued to experience low-grade fever, leading to the decision for laparoscopic exploration and subsequent appendectomy. Pathological findings confirmed the presence of appendicitis. After the surgical procedure, the patient's temperature and infectious markers returned to within normal range, ultimately leading to a diagnosis of appendicitis.

CONCLUSIONS

The atypical symptoms and signs, along with the negative imaging results, contribute to the under diagnosis of appendicitis and the progression of fever of unknown origin, thereby exacerbating the physical, mental, and economic burden on patients. Consequently, there are valuable insights to be gained regarding the management of both appendicitis and fever of unknown origin.

摘要

背景

发热原因不明的诊断和处理在传染病领域具有挑战性,因为它受到多种因素的影响。传染病一直被认为是发热原因不明的主要病因。然而,并非所有传染病都能明确确定病原体和感染部位。

病例介绍

我们报告了一例发热、恶心和厌食的病例,但未报告任何腹痛。体格检查未发现腹部压痛的迹象。包括增强 CT 和阑尾彩色超声在内的重复影像学检查,仅一次彩色超声提示阑尾炎的可能性。尽管进行了有效的抗感染治疗,患者仍持续低热,因此决定进行腹腔镜探查和随后的阑尾切除术。病理检查证实存在阑尾炎。手术后,患者的体温和感染标志物恢复正常范围,最终诊断为阑尾炎。

结论

不典型的症状和体征,加上阴性的影像学结果,导致阑尾炎和发热原因不明的诊断不足,加重了患者的身体、心理和经济负担。因此,对于阑尾炎和发热原因不明的处理有重要的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3208/11409626/cf5669fc341b/12879_2024_9851_Fig1_HTML.jpg

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