Elbahr Umran, Erdem Hakan, Ben Yahia Wissal, Baymakova Magdalena Petrova, Letaief Amel, Poposki Kostadin, Grgić Svjetlana, Sanlidag Gamze, Miftode Ionela-Larisa, Marino Andrea, Miftode Egidia Gabriela, Amer Fatma, Oncu Serkan, Hasanoglu Imran, Wegdan Ahmed Ashraf, Eser Fatma, Guner Hatice Rahmet, Kaya Kalem Ayse, Cosentino Federica, Kolovani Entela, Tahmaz Alper, Sonmezer Meliha Cagla, Arapovic Jurica, Ceylan Mehmet Resat, Kayaaslan Bircan, Hakamifard Atousa, Önder Taylan, Eser-Karlidag Gulden, Tehrani Hamed Azhdari, Addepalli Syam Kumar, Kumari Hema Prakash, Kumar Meela Ranjith, Sayana Suresh Babu, Sipahi Oguz Resat
Infectious Diseases Department, Bahrain Oncology Center, King Hamad University Hospital, Muharraq, Bahrain.
Department of Infectious Diseases and Clinical Microbiology, Turkish Health Sciences University, Gulhane School of Medicine, Ankara, Türkiye.
Medicine (Baltimore). 2025 Jul 18;104(29):e43341. doi: 10.1097/MD.0000000000043341.
Herein, we aimed to analyze the final diagnosis in a well-defined cohort of fever of unknown origin (FUO) cases whose erythrocyte sedimentation rate (ESR) was 100 mm/h or more during the admission. The subgroup of the FUO patients with an ESR of 100 mm/h or more during the FUO evaluation, was extracted from the study database of a previously published multicenter study (European Journal of Clinical Microbiology & Infectious Diseases. April 15, 2023;42 (4):387-98). Data for 139 patients (17.6%, 139/788 of the original cohort) who fulfilled the study inclusion criteria, were obtained from 29 centers from 11 countries. Infections, neoplasms, and noninfectious inflammatory diseases were found to be the reason of fever in [n = 74 (53.2%)], [n = 14 (10%)], and [n = 13 (9.3%)] of 139 patients, respectively. Regardless of the diseases subgroup top 6 diseases that were determined to be the reasons of FUO were tuberculosis [n = 15 (10.8%)], HIV/AIDS [n = 13 (9.3%)], urinary tract infection [n = 9 (6.5%)], infective endocarditis [n = 9 (6.5%)], lymphoma [n = 9 (6.5%)], and abscess [n = 9 (6.5%)]. The most common infectious diseases were tuberculosis (15/74, 20.2%), HIV/AIDS (13/74, 17.5%), and infective endocarditis (9/74, 12.1%), along with urinary tract infection [n = 9 (6.5%)] and abscess [n = 9 (6.5%)]. The most common noninfectious inflammatory diseases were adult onset Still disease (3/13, 23%) and giant cell arteritis, also known as temporal arteritis (3/13, 23%), and followed by polyarteritis nodosa (2/13, 15.3%). The most common neoplasm was lymphoma (9/14, 64.2%), followed by lung cancer (2/14, 14.2%). Reason of fever could not be defined in (29/139, 20.8%) patients. The invasive procedures were performed in (64/139, 46%) patients. Gender, age > 50 or not, and income level (high-middle-low) of the participating country were not associated with a significant difference in the final diagnosis category of the FUO case (P > .05). To the best of our knowledge, this is the first study evaluating the FUO in the subgroup of cases with extreme ESR elevation and infectious diseases comprised the most cause of the FUO in this particular subgroup.
在此，我们旨在分析一组明确的不明原因发热（FUO）病例的最终诊断结果，这些病例在入院时红细胞沉降率（ESR）为100毫米/小时或更高。FUO评估期间ESR为100毫米/小时或更高的FUO患者亚组，是从先前发表的一项多中心研究（《欧洲临床微生物学与传染病杂志》。2023年4月15日；42(4):387 - 98）的研究数据库中提取的。符合研究纳入标准的139例患者（占原队列的17.6%，139/788）的数据，来自11个国家的29个中心。在139例患者中，感染、肿瘤和非感染性炎症性疾病分别被发现是[n = 74（53.2%）]、[n = 14（10%）]和[n = 13（9.3%）]发热的原因。无论疾病亚组如何，被确定为FUO原因的前6种疾病是结核病[n = 15（10.8%）]、艾滋病毒/艾滋病[n = 13（9.3%）]、尿路感染[n = 9（6.5%）]、感染性心内膜炎[n = 9（6.5%）]、淋巴瘤[n = 9（6.5%）]和脓肿[n = 9（6.5%）]。最常见的感染性疾病是结核病（15/74，20.2%）、艾滋病毒/艾滋病（13/74，17.5%）和感染性心内膜炎（9/74，12.1%），以及尿路感染[n = 9（6.5%）]和脓肿[n = 9（6.5%）]。最常见的非感染性炎症性疾病是成人斯蒂尔病（3/13，23%）和巨细胞动脉炎，也称为颞动脉炎（3/13，23%），其次是结节性多动脉炎（2/13，15.3%）。最常见的肿瘤是淋巴瘤（9/14，64.2%），其次是肺癌（2/14，14.2%）。（29/139，20.8%）的患者发热原因无法明确。（64/139，46%）的患者进行了侵入性检查。参与国家的性别、年龄是否大于50岁以及收入水平（高 - 中 - 低）与FUO病例的最终诊断类别无显著差异（P > 0.05）。据我们所知，这是第一项评估ESR极度升高亚组中FUO的研究，在这个特定亚组中，感染性疾病是FUO的最主要原因。
