TY - JOUR
T1 - Analysis of 256 cases of classic fever of unknown origin
AU - Yamanouchi, Masashi
AU - Uehara, Yuki
AU - Yokokawa, Hirohide
AU - Hosoda, Tomohiro
AU - Watanabe, Yukiko
AU - Shiga, Takayoshi
AU - Inui, Akihiro
AU - Otsuki, Yukiko
AU - Fujibayashi, Kazutoshi
AU - Isonuma, Hiroshi
AU - Naito, Toshio
N1 - Publisher Copyright:
© 2014 The Japanese Society of Internal Medicine.
PY - 2014
Y1 - 2014
N2 - Objective The causes of fever of unknown origin (FUO) vary depending on the region and time period. We herein present a study of patients with classic FUO where we investigated differences based on patient background factors, such as age and causative diseases, and changes that have occurred over time.Methods We extracted and analyzed data from the medical records of 256 patients ≥18 years old who met the criteria for classic FUO and were hospitalized between August, 1994 and December, 2012.Results The median age of the patients was 55 years (range: 18-94 years). The cause of FUO was infection in 27.7% of the patients (n=71), non-infectious inflammatory disease (NIID) in 18.4% (47), malignancy in 10.2% (26), other in 14.8% (38), and unknown in 28.9% (74). The most common single cause was human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (n=17). NIID and malignancy were more common in patients ≥65 years old than in patients <65 years old. During 2004-2012, compared to 1994-2003, infections and “other” causes were decreased, whereas NIID, malignancy, and unknown causes were increased.Conclusion FUO associated with HIV/AIDS is increasing in Japan. In addition, as in previous studies in Japan and overseas, our study showed that the number of patients in whom the cause of FUO remains unknown is increasing and exceeds 20% of all cases. The present study identified diseases that should be considered in the differential diagnosis of FUO, providing useful information for the future diagnosis and treatment of FUO.
AB - Objective The causes of fever of unknown origin (FUO) vary depending on the region and time period. We herein present a study of patients with classic FUO where we investigated differences based on patient background factors, such as age and causative diseases, and changes that have occurred over time.Methods We extracted and analyzed data from the medical records of 256 patients ≥18 years old who met the criteria for classic FUO and were hospitalized between August, 1994 and December, 2012.Results The median age of the patients was 55 years (range: 18-94 years). The cause of FUO was infection in 27.7% of the patients (n=71), non-infectious inflammatory disease (NIID) in 18.4% (47), malignancy in 10.2% (26), other in 14.8% (38), and unknown in 28.9% (74). The most common single cause was human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (n=17). NIID and malignancy were more common in patients ≥65 years old than in patients <65 years old. During 2004-2012, compared to 1994-2003, infections and “other” causes were decreased, whereas NIID, malignancy, and unknown causes were increased.Conclusion FUO associated with HIV/AIDS is increasing in Japan. In addition, as in previous studies in Japan and overseas, our study showed that the number of patients in whom the cause of FUO remains unknown is increasing and exceeds 20% of all cases. The present study identified diseases that should be considered in the differential diagnosis of FUO, providing useful information for the future diagnosis and treatment of FUO.
KW - Human immunodeficiency virus/acquired immunodeficiency syndrome
KW - Image studies
KW - Malignant lymphoma
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U2 - 10.2169/internalmedicine.53.2218
DO - 10.2169/internalmedicine.53.2218
M3 - Article
C2 - 25366005
AN - SCOPUS:84908391052
SN - 0918-2918
VL - 53
SP - 2471
EP - 2475
JO - Internal Medicine
JF - Internal Medicine
IS - 21
ER -