老年人不明原因发热45例

目的 分析老年人不明原因发热（FUO）的病因。方法 选择1999年1月。2004年12月符合FUO诊断标准的老年患者45例进行分析。结果 40例（88.9％）老年FUO患者通过血清学和（或）细菌学、体液或骨髓、组织活检、手术探查以及观察临床过程和（或）治疗反应明确诊断。感染性疾病占42.5％（17／40），其中结核病8例，占感染性疾病的47％（8／17），肿瘤性疾病占35％（14／40），结缔组织病占12.5％（5／40），其他疾病占10％（4／40），病因不明占11，1％（5／40）。结论 感染是我院老年FUO患者的主要病因，其次为肿瘤性疾病和结缔组织病。正确的诊断策略可提高确诊率，减少或避免误诊或漏诊。

Fever of unknown origin in 45 elderly patients

Objective To analysis the etiological factors of (fever of unknown origin FUO) in the elderly.Methods We prospectively collected a series of 45 elderly patients with FUO referred to our hospital from Jan.1999 to Dec.2004.Results A final diagnosis was established in 40 elderly patients(88.9%),by using laboratory tests and diagnostic tools,such as serology or/and bacteriology,body fluid,bone marrow,tissue biopsy,surgical exploration as well as observing clinical procedure or/and therapeutic response.Among the 40 patients with a final diagnosis,the most common causes of FUO were infectious diseases(42.5%),with tuberculosis accouting for 47% of cases of infection.35% (14/40) of the FUO cases were diagnosed as malignancy.Five patients were suffered from collagen vascular diseases (CVD).Miscellaneous causes were found in 10% (4/40) of the FUO cases.However,there still 5 (11.1%) undiagnosed cases.Conclusion The most common causes of FUO in the elderly were infectious diseases in our hospital,malignancy and CVD were also major causes of FUO.Right diagnostic strategy can raise the diagnosis rate of FUO and decrease or avoid misdiangnosis and missed diagnosis.