Fever of Unknown Origin: A Clinical Approach

被引：86

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

页码：1138.e1 / 1138.e15

页数：15

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