PDF(Pubmed)
Abstract：
Fever of unknown origin (FUO) can be caused by four etiological categories of diseases. The most common cause of FUO in children is represented by infections, followed by inflammatory conditions and neoplastic causes; a decreasing quote remains still without diagnosis. Despite the fact that several diagnostic and therapeutic approaches have been proposed since the first definition of FUO, none of them has been fully validated in pediatric populations. A focused review of the patient\'s history and a thorough physical examination may offer helpful hints in suggesting a likely diagnosis. The diagnostic algorithm should proceed sequentially, and invasive testing should be performed only in select cases, possibly targeted by a diagnostic suspect. Pioneering serum biomarkers have been developed and validated; however, they are still far from becoming part of routine clinical practice. Novel noninvasive imaging techniques have shown promising diagnostic accuracy; however, their positioning in the diagnostic algorithm of pediatric FUO is still not clear. This narrative review aims to provide a synopsis of the existent literature on FUO in children, with its major causes and possible diagnostic workup, to help the clinician tackle the complex spectrum of pediatric FUO in everyday clinical practice.
摘要：
不明原因发热（FUO）可由四种病因学类别的疾病引起。FUO在儿童中最常见的原因是感染，其次是炎症和肿瘤的原因;不断减少的报价仍然没有诊断。尽管自FUO的第一个定义以来，已经提出了几种诊断和治疗方法，它们均未在儿科人群中得到充分验证.对患者病史的重点审查和全面的体格检查可能为提示可能的诊断提供有用的提示。诊断算法应按顺序进行，和侵入性测试应该只在选定的情况下进行，可能是诊断嫌疑犯的目标.已经开发和验证了开创性的血清生物标志物；然而，它们还远未成为常规临床实践的一部分。新的非侵入性成像技术已显示出有希望的诊断准确性；然而，其在儿科FUO诊断算法中的定位尚不清楚。这篇叙述性综述旨在提供关于儿童FUO的现有文献的概要，其主要原因和可能的诊断工作，帮助临床医生在日常临床实践中解决儿科FUO的复杂频谱。
