Nedeni Bilinmeyen Ateş
Özet
Ateş yakınması ile gelen bir hastada; ateş 3 haftadan uzun süredir devam ediyor, birden fazla ölçümde 38,3ºC’yi geçiyor ve her türlü çabaya rağmen nedeni ortaya çıkarılamıyorsa bu durum “Nedeni Bilinmeyen Ateş” (NBA) olarak ifade edilir. Bu bölümde, tıbbi olanaklarda her geçen gün kaydedilen ilerlemeler sayesinde son yıllarda görülme sıklığı azalan NBA’nın nedenleri, teşhis yöntemleri ve tedavisindeki kurallar incelendi. NBA olgularında multidisipliner olarak değerlendirilmesi ve özel hasta grupları dışında empirik tedaviden kaçınılması gerektiği vurgulanmaya çalışıldı.
In a patient presenting with fever; if the fever continues for more than 3 weeks, exceeds 38.3 °C in more than one measurement and the cause cannot be determined despite all efforts, this situation is referred to as “ Fever of Unknown Origin” (FUO). In this section, the causes, diagnostic methods and treatment rules of FUO, whose incidence has decreased in recent years thanks to the advancements in medical facilities, were examined. It was tried to emphasize that FUO cases should be evulated multidisciplinaryly and empirical treatment should be avoided except for special patient groups.
Referanslar
Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore). 1961 Feb;40:1-30. doi: 10.1097/00005792-196102000-00001.
Durack DT, Street AC. Fever of unknown origin--reexamined and redefined. Curr Clin Top Infect Dis. 1991;11:35-51.
Spelman D, Sexton DJ, Hall KK.Fever of unknown origin in adults: Evaluatiin and management [Online]. http://uptodate.com/contents/fever-of-unknown-origin-in-adults-evulation-and-management? [Accessed: 9th August 2024].
Mulders-Manders C, Simon A, Bleekers-Rovers C. Fever of unknown origin. Clin Med. 2015;15(3):280-284. doi:10.7861/clinmedicine.15-3-280.
David A, Quinlan JD. Fever of unknown origin in adults. Am Fam Physician. 2022;105(2):137-143. https://aafp.org/afp/2022/0200/p137-s1.
De Kleijin EMHA, Vandenbroucke JP, Van Der Meer, et al. Fever of unknown origin. Medicine 1997; 76:392-400.
Fusco FM, Pisapia R, Nardiello S, et al. Fever of unknown origin (FUO): which are the factors influencing the final diagnosis ? A 2005-2015 systematic review. BMC Infect Dis.2019; 19:653. doi: 10.1186/s12879—019-4285-8.
Wright WF, Yenokyan G, Simner PJ, et al.Geographic variation of infectious disease diagnoses among patients with fever of unknown origin: a systematic review and meta-analysis. Open Forum Infectious Diseases.2022;9(5):ofac 151. doi:10.1093/ofid/ofac151.
Zhou G, Zhou Y, Zhong C, et al. Retrospective analysis of 1.641 cases of classic fever of unknown origin. Ann Transl Med. 2020;8(11):690. doi: 10.21037/atm-20-3875.
Naito T, Tanei M, Ikeda N, et al. Key diagnostic characteristicsof fever of unknown origin in Japanese patients: a prospective multicentre study. BMJ Open.2019;9:e032059. doi:10.1136/bmjopen-2019-032-059.
Erdem H, Baymakova M, Alkan S, et al. Classical fever of unknown origin in 21 countries with different economic development : an international ID-IRI study. Eur J Clin Microbiol. 2023;42:387-398. doi: 10.1007/s10096-023-04561-5.
Saltoğlu N, Taşova Y, Midikli D, et al. Fver of unknown origin in Turkey: evaluation of 87 cases during a nine year period of study. J Infect.2004;48:81-85. doi:10.1016/j.jinf.2003.08.006.
Sipahi OR, Senol S, Arsu G, et al. Pooled analysis of 857 published adult fever of unknown origin cases in Turkey between 1990-2006. Med Sci Monit. 2007;13(7):CR318-22.
Küçükardalı Y, Öncül O, Çavuşku Ş, et al. The spectrum of diseases causing fever of unknown origin in Turkey: a multicenter study. Int J Infect.2008;12(1):71-79. doi:10.1016//j.ijid.2007.04.013.
Mete B, Vanlı E, Yemişen M, et al. The role of invasive and non-invasive procedures in diagnosing fever of unknown origin. Int J Med Sci.2012;9(8):682-689. doi:10.7150/ijms.4591.
Yenilmez E, Kakaliçoğlu D, Bozkurt F, et al. Fever of unkonown origin (FUO) on a land on cross-roads between Asia and Europa; a multicenter study from Turkey. Int J Clin Pract.2021;00:e14138. doi.org/10.1111/ijcp.14138.
Bosilkovski M, Dimzova M, Stevanović M, et al. Fever of unknown origin-diagnostic methods in a European developing country. Vojnosanit Pregl.2016;73(6):553-558. doi:10.2298/vsp140827050b.
Tabak F. Enfeksiyon Hastalıkları içinde. İstanbul:İstanbul Medikal Sağlık ve Yayıncılık Hiz.Tic.Ltd.Şti; 2019. p.101-110.
Cunha BA, Lortholary O, Cunha CB. Fever of unknown origin: A cilinical approach. Am J Med. 2015;128(10):p1138.e1-1138. doi: 10.1016/jamjmed.2015.06.001.
Demircan C. Uludağ İç Hastalıkları Kitabı,Cilt-2, Semptomdan Tanıya. Bursa: Bursa Uludağ Yayınları, 2022.
Hayakawa K, Ramasamy B, Chandrasekar PH. Fever of unknown origin: An evidence-based review. Am J Med Sci. 2012;344(4):307-316. doi:10.1097/MAJ.0b013e31824ae504.
Referanslar
Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore). 1961 Feb;40:1-30. doi: 10.1097/00005792-196102000-00001.
Durack DT, Street AC. Fever of unknown origin--reexamined and redefined. Curr Clin Top Infect Dis. 1991;11:35-51.
Spelman D, Sexton DJ, Hall KK.Fever of unknown origin in adults: Evaluatiin and management [Online]. http://uptodate.com/contents/fever-of-unknown-origin-in-adults-evulation-and-management? [Accessed: 9th August 2024].
Mulders-Manders C, Simon A, Bleekers-Rovers C. Fever of unknown origin. Clin Med. 2015;15(3):280-284. doi:10.7861/clinmedicine.15-3-280.
David A, Quinlan JD. Fever of unknown origin in adults. Am Fam Physician. 2022;105(2):137-143. https://aafp.org/afp/2022/0200/p137-s1.
De Kleijin EMHA, Vandenbroucke JP, Van Der Meer, et al. Fever of unknown origin. Medicine 1997; 76:392-400.
Fusco FM, Pisapia R, Nardiello S, et al. Fever of unknown origin (FUO): which are the factors influencing the final diagnosis ? A 2005-2015 systematic review. BMC Infect Dis.2019; 19:653. doi: 10.1186/s12879—019-4285-8.
Wright WF, Yenokyan G, Simner PJ, et al.Geographic variation of infectious disease diagnoses among patients with fever of unknown origin: a systematic review and meta-analysis. Open Forum Infectious Diseases.2022;9(5):ofac 151. doi:10.1093/ofid/ofac151.
Zhou G, Zhou Y, Zhong C, et al. Retrospective analysis of 1.641 cases of classic fever of unknown origin. Ann Transl Med. 2020;8(11):690. doi: 10.21037/atm-20-3875.
Naito T, Tanei M, Ikeda N, et al. Key diagnostic characteristicsof fever of unknown origin in Japanese patients: a prospective multicentre study. BMJ Open.2019;9:e032059. doi:10.1136/bmjopen-2019-032-059.
Erdem H, Baymakova M, Alkan S, et al. Classical fever of unknown origin in 21 countries with different economic development : an international ID-IRI study. Eur J Clin Microbiol. 2023;42:387-398. doi: 10.1007/s10096-023-04561-5.
Saltoğlu N, Taşova Y, Midikli D, et al. Fver of unknown origin in Turkey: evaluation of 87 cases during a nine year period of study. J Infect.2004;48:81-85. doi:10.1016/j.jinf.2003.08.006.
Sipahi OR, Senol S, Arsu G, et al. Pooled analysis of 857 published adult fever of unknown origin cases in Turkey between 1990-2006. Med Sci Monit. 2007;13(7):CR318-22.
Küçükardalı Y, Öncül O, Çavuşku Ş, et al. The spectrum of diseases causing fever of unknown origin in Turkey: a multicenter study. Int J Infect.2008;12(1):71-79. doi:10.1016//j.ijid.2007.04.013.
Mete B, Vanlı E, Yemişen M, et al. The role of invasive and non-invasive procedures in diagnosing fever of unknown origin. Int J Med Sci.2012;9(8):682-689. doi:10.7150/ijms.4591.
Yenilmez E, Kakaliçoğlu D, Bozkurt F, et al. Fever of unkonown origin (FUO) on a land on cross-roads between Asia and Europa; a multicenter study from Turkey. Int J Clin Pract.2021;00:e14138. doi.org/10.1111/ijcp.14138.
Bosilkovski M, Dimzova M, Stevanović M, et al. Fever of unknown origin-diagnostic methods in a European developing country. Vojnosanit Pregl.2016;73(6):553-558. doi:10.2298/vsp140827050b.
Tabak F. Enfeksiyon Hastalıkları içinde. İstanbul:İstanbul Medikal Sağlık ve Yayıncılık Hiz.Tic.Ltd.Şti; 2019. p.101-110.
Cunha BA, Lortholary O, Cunha CB. Fever of unknown origin: A cilinical approach. Am J Med. 2015;128(10):p1138.e1-1138. doi: 10.1016/jamjmed.2015.06.001.
Demircan C. Uludağ İç Hastalıkları Kitabı,Cilt-2, Semptomdan Tanıya. Bursa: Bursa Uludağ Yayınları, 2022.
Hayakawa K, Ramasamy B, Chandrasekar PH. Fever of unknown origin: An evidence-based review. Am J Med Sci. 2012;344(4):307-316. doi:10.1097/MAJ.0b013e31824ae504.
