Naschitz J E, Yeshurun D
Isr J Med Sci. 1985 Dec;21(12):995-8.
Dental infections, otitis media or sinusitis may present as fever of unknown origin (FUO), lacking local symptoms and signs. Physicians are often unaware of this possibility, since current textbooks and major articles do not mention occult facial infections among the causes of FUO. Patients with FUO typically undergo a laborious series of uncomfortable, time-consuming, expensive and often unnecessary investigations in the search for the cause of pyrexia. We report five such patients from a community hospital, representing 14% of cases in a series of patients with FUO. In most of these patients local signs were absent, laboratory investigations were noncontributory, and antibiotic treatment was ineffective. Surgical drainage of pus collections was followed a few days later by defervescence. We suggest that occult infections in the facial area should be considered among the common causes of FUO, and careful dental examination, otoscopy and X-rays of the teeth and sinuses should be included early in the investigation of these patients.
牙科感染、中耳炎或鼻窦炎可能表现为不明原因发热（FUO），缺乏局部症状和体征。医生往往没有意识到这种可能性，因为当前的教科书和主要文章在不明原因发热的病因中并未提及隐匿性面部感染。不明原因发热的患者通常要经历一系列繁琐、不舒服、耗时、昂贵且往往不必要的检查，以寻找发热的原因。我们报告了来自一家社区医院的5例此类患者，占一系列不明原因发热患者病例的14%。在这些患者中，大多数没有局部体征，实验室检查无诊断价值，抗生素治疗无效。几天后，对脓肿进行手术引流，随后体温下降。我们建议，面部隐匿性感染应被视为不明原因发热的常见病因之一，在对这些患者进行调查时，应尽早进行仔细的牙科检查、耳镜检查以及牙齿和鼻窦的X光检查。
