Clinical analysis of 212 patients with fever of unknown origin

Objective To analyze the etiology and diagnosis of fever of unknown origin (FUO), and improve the early diagnosis and treatment of FUO. Methods Total 212 patients met FUO diagnostic criteria in our hospital between January, 2012 to January, 2015 were enrolled into this study. All the patients were grouped by gender and age. The distribution of etiology in gender and age was analyzed. The data was analyzed by SPSS 19. 0, Chi-square test and T test were used to compare the differences between different groups of qualitative or quantitative data. The p-value of 0. 05 was considered on the borderline of statistical significance. Results A total of 171 cases (80. 66%) were confirmed with FUO by relevant examination or diagnostic treatment, and 41 cases (19. 34%) still to be confirmed. The overall etiology distribution was as follows:98 (57. 31%) were infectious diseases (72. 45% bacterial infection and 25. 51% tuberculosis); 27 (15. 79%) were connective tissue diseases (CTD) in which adult-onset Still's disease accounted for 44. 44% (12/27); 17 (9. 94%) were tumor in which lymphoma accounted for 35. 29% (6/17); 29 were other diseases in which drug fever accounted for 41. 38% (12/29) and necrotizing lymphadenitis for 24. 14% (7/29). There was a higher incidence of CTD in women and of tumor diseases in men, the difference was statistically significant (P < 0. 05), But the incidence of infectious disease, other diseases, and uncertain diagnosis cases among the different gender group was not statistically significant (P > 0. 05).The infectious diseases in all age groups were the primary cause, especially in 60 or over age group; The CTD was common in 30 to 59 age group, malignant tumor diseases were common in 60-86 age group, the difference was statistically significant among the different age groups (χ²=17. 521, P=0. 025). Conclusion The etiology of FUO is complex, infectious diseases are common. The bacterial infection and infection of mycobacterium tuberculosis accounted for an important position, in which the diagnosis of extrapulmonary tuberculosis is focal and difficult point; the percentage of the CTD and tumor are also relatively high. FUO can be generally diagnosed definitely in most cases through detailed history and necessary physical examination.