Fever of Unknown Origin: A Clinical Approach

被引：80
作者：
Cunha, Burke A. [1 ,2 ]
Lortholary, Olivier [3 ,4 ]
Cunha, Cheston B. [5 ,6 ,7 ]
机构：
[1] Winthrop Univ Hosp, Div Infect Dis, Mineola, NY 11501 USA
[2] SUNY Stony Brook, Sch Med, Stony Brook, NY 11794 USA
[3] Hop Necker Enfants Malad, Serv Malad Infect & Trop, Ctr Infectiol Necker Pasteur, IHU Imagine, Paris, France
[4] Univ Paris 05, Paris, France
[5] Rhode Isl Hosp, Div Infect Dis, Providence, RI USA
[6] Miriam Hosp, Providence, RI 02906 USA
[7] Brown Univ, Alpert Sch Med, Providence, RI 02912 USA
来源：
AMERICAN JOURNAL OF MEDICINE | 2015年 / 128卷 / 10期
关键词：
Adult fevers of unknown origin; Focused diagnostic approach; Fevers of unknown origin; HUMAN-IMMUNODEFICIENCY-VIRUS; JUVENILE RHEUMATOID-ARTHRITIS; ACTIVE ANTIRETROVIRAL THERAPY; DIAGNOSTIC-SIGNIFICANCE; INFECTED PATIENTS; RECURRENT FEVER; RISK-FACTORS; SUBACUTE THYROIDITIS; UNDETERMINED ORIGIN; PERIODIC FEVER;
D O I：
10.1016/j.amjmed.2015.06.001
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Fevers of unknown origin remain one of the most difficult diagnostic challenges in medicine. Because fever of unknown origin may be caused by over 200 malignant/neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders, clinicians often order non-clue-based imaging and specific testing early in the fever of unknown origin work-up, which may be inefficient/misleading. Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach. Characteristic history and physical examination findings together with key nonspecific test abnormalities are the basis for a focused clue-directed fever of unknown origin work-up. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码：1138.e1 / 1138.e15
页数：15
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