Abstract：
BACKGROUND: Fever of unknown origin (FUO) is a diagnostic challenge with highly heterogeneous causes. Its etiology can change according to the studied regions, and the chance of reaching a diagnosis depends on available resources. The aim of this study is to describe the clinical characteristics, etiology and the usefulness of diagnostic aids in cases of FUO managed over 12 years in a Colombian reference center.
METHODS: Single-institution retrospective case series. All cases of FUO between 2006 and 2017 were identified with the help of an electronic medical record search software. Cases of adults with fever for more than three weeks who remained undiagnosed after three days of hospitalization are described.
RESULTS: Of 1,009 cases evaluated, 112 cases met the inclusion criteria (median age 43 years, 66% men). The etiologies identified were infectious (31.2%), inflammatory (20.5%), neoplastic (14.3%), and miscellaneous (2.7%) diseases. 31.2% remained without etiological diagnosis. The most frequent conditions were tuberculosis (17%), Hodgkin\'s lymphoma (7.1%), systemic lupus erythematosus (6.3%), disseminated histoplasmosis, and adult Still\'s disease. Contrast tomography and biopsies were the studies that most frequently supported or confirmed the final diagnosis.
CONCLUSIONS: This series of contemporary Latin American cases suggests that the categories of FUO etiologies are similar to those reported in studies from developed countries, with tuberculosis being the most frequent cause in our setting. Our results highlight the importance of tomography-guided invasive studies in the diagnostic approach to FUO.
METHODS: Single-institution retrospective case series. All cases of FUO between 2006 and 2017 were identified with the help of an electronic medical record search software. Cases of adults with fever for more than three weeks who remained undiagnosed after three days of hospitalization are described.
RESULTS: Of 1,009 cases evaluated, 112 cases met the inclusion criteria (median age 43 years, 66% men). The etiologies identified were infectious (31.2%), inflammatory (20.5%), neoplastic (14.3%), and miscellaneous (2.7%) diseases. 31.2% remained without etiological diagnosis. The most frequent conditions were tuberculosis (17%), Hodgkin\'s lymphoma (7.1%), systemic lupus erythematosus (6.3%), disseminated histoplasmosis, and adult Still\'s disease. Contrast tomography and biopsies were the studies that most frequently supported or confirmed the final diagnosis.
CONCLUSIONS: This series of contemporary Latin American cases suggests that the categories of FUO etiologies are similar to those reported in studies from developed countries, with tuberculosis being the most frequent cause in our setting. Our results highlight the importance of tomography-guided invasive studies in the diagnostic approach to FUO.
摘要：
背景：不明原因发热（FUO）是一种具有高度异质性原因的诊断挑战。其病因可以根据研究区域而变化，诊断的机会取决于可用的资源。这项研究的目的是描述临床特征，在哥伦比亚参考中心管理超过12年的FUO病例中，病因和诊断辅助工具的有用性。
方法：单机构回顾性病例系列。在电子病历搜索软件的帮助下，识别了2006年至2017年的所有FUO病例。描述了发烧超过三周的成年人在住院三天后仍未被诊断的病例。
结果：在评估的1,009例中，112例符合纳入标准(中位年龄43岁，66%的男性）。确定的病因为传染性（31.2％），炎症（20.5%），肿瘤（14.3%），和杂项(2.7%)疾病。31.2%无病因诊断。最常见的疾病是结核病（17％），霍奇金淋巴瘤（7.1%），系统性红斑狼疮（6.3%），播散性组织胞浆菌病，和成人斯蒂尔病。造影断层扫描和活检是最经常支持或确认最终诊断的研究。
结论：这一系列当代拉丁美洲病例表明，FUO病因的类别与发达国家研究报告的相似，结核病是我们环境中最常见的原因。我们的结果强调了断层摄影术指导的侵入性研究在FUO诊断方法中的重要性。
方法：单机构回顾性病例系列。在电子病历搜索软件的帮助下，识别了2006年至2017年的所有FUO病例。描述了发烧超过三周的成年人在住院三天后仍未被诊断的病例。
结果：在评估的1,009例中，112例符合纳入标准(中位年龄43岁，66%的男性）。确定的病因为传染性（31.2％），炎症（20.5%），肿瘤（14.3%），和杂项(2.7%)疾病。31.2%无病因诊断。最常见的疾病是结核病（17％），霍奇金淋巴瘤（7.1%），系统性红斑狼疮（6.3%），播散性组织胞浆菌病，和成人斯蒂尔病。造影断层扫描和活检是最经常支持或确认最终诊断的研究。
结论：这一系列当代拉丁美洲病例表明，FUO病因的类别与发达国家研究报告的相似，结核病是我们环境中最常见的原因。我们的结果强调了断层摄影术指导的侵入性研究在FUO诊断方法中的重要性。
