Uzamış Ateş
Özet
Bu metin, tıbbi literatürde tanısal bir zorluk olarak kabul edilen "uzamış ateş" ve "nedeni bilinmeyen ateş" (NBA) kavramlarını kapsamlı bir şekilde ele almaktadır. Yazıda, ateşin tanımı, tarihsel süreçteki kategorizasyon değişiklikleri ve altta yatan enfeksiyöz, enflamatuvar ile neoplastik nedenler detaylıca analiz edilmektedir. Ayrıca, doğru teşhis için ayrıntılı öykü alımı, fizik muayene rutinleri ve laboratuvar testlerinin önemi vurgulanarak klinisyenler için stratejik bir yol haritası sunulmaktadır.
This text comprehensively examines the concepts of "prolonged fever" and "fever of unknown origin" (FUO), which are considered significant diagnostic challenges in medical literature. The article provides a detailed analysis of the definition of fever, its historical categorization changes, and underlying infectious, inflammatory, and neoplastic causes. Furthermore, it offers a strategic roadmap for clinicians by emphasizing the importance of detailed history taking, physical examination routines, and laboratory tests for an accurate diagnosis.
Referanslar
World Health Organization. Fever measured temperature [Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/180.
Centers for Disease Control and Prevention. Definitions of Symptoms for Reportable Illnesses [Available from: https://www.cdc.gov/quarantine/air/reporting-deaths-illness/definitions-symptoms-reportable-illnesses.html#:~:text=CDC%20considers%20a%20person%20to,history%20of%20feeling%20feverish.
Lorenzi OD, Gregory CJ, Santiago LM, et al. Acute febrile illness surveillance in a tertiary hospital emergency department: comparison of influenza and dengue virus infections. Am J Trop Med Hyg. 2013;88(3):472-480.
Preston TW. The investigation of prolonged pyrexia. Postgrad Med J. 1946;22(254):405-408.
Cunha BA. Fever of unknown origin: clinical overview of classic and current concepts. Infect Dis Clin North Am. 2007;21(4):867-915, vii.
Petersdorf RG, Beeson PB. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore). 1961;40:1-30.
Durack DT, Street AC. Fever of unknown origin--reexamined and redefined. Curr Clin Top Infect Dis. 1991;11:35-51.
Eskerud JR, Laerum E, Fagerthun H, et al. Fever in general practice. I. Frequency and diagnoses. Fam Pract. 1992;9(3):263-269.
Tun ZM, Moorthy M, Linster M, et al. Characteristics of acute febrile illness and determinants of illness recovery among adults presenting to Singapore primary care clinics. BMC Infect Dis. 2016;16(1):612.
Cunha BA, Lortholary O, Cunha CB. Fever of unknown origin: a clinical approach. Am J Med. 2015;128(10):1138 e1131-1138 e1115.
Bleeker-Rovers CP, Vos FJ, de Kleijn E, et al. A prospective multicenter study on fever of unknown origin: the yield of a structured diagnostic protocol. Medicine (Baltimore). 2007;86(1):26-38.
de Kleijn EM, Vandenbroucke JP, van der Meer JW. Fever of unknown origin (FUO). I A. prospective multicenter study of 167 patients with FUO, using fixed epidemiologic entry criteria. The Netherlands FUO Study Group. Medicine (Baltimore). 1997;76(6):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(1):653.
Miller RF, Hingorami AD, Foley NM. Pyrexia of undetermined origin in patients with human immunodeficiency virus infection and AIDS. Int J STD AIDS. 1996;7(3):170-175.
Brown I, Finnigan NA. Fever of Unknown Origin. 2021. In: StatPearls [Internet]. Treasure Island (FL). Available from: https://www.ncbi.nlm.nih.gov/pubmed/30335298.
Brusch JL, Weinstein L. Fever of Unknown Origin. Medical Clinics of North America. 1988;72(5):1247-1261.
Yenen OS. Ateş ve nedeni bilinmeyen ateş. In: Topcu AW, Soyletir G, Doğanay M, editors. Enfeksiyon hastalıkları ve mikrobiyolojisi. 1. 3 ed. İstanbul: Nobel tıp kitabevi; 2008. p. 520-521.
Cunha BA. The diagnostic significance of relative bradycardia in infectious disease. Clin Microbiol Infect. 2000;6(12):633-634.
Cunha CB. Infectious disease differential diagnosis. In: Cunha BA, editor. Antibiotic Essentials. 14 ed. New Delhi, India: Jaypee Brothers Medical Publishers; 2015. p. 475-506.
Bosilkovski M, Baymakova M, Dimzova MJRJIM. Fever of Unknown Origin (FUO): towards uniform definitions and classification. 2020;42(2):121-126.
Hersch EC, Oh RC. Prolonged febrile illness and fever of unknown origin in adults. Am Fam Physician. 2014;90(2):91-96.
Limper M, de Kruif MD, Duits AJ, et al. The diagnostic role of procalcitonin and other biomarkers in discriminating infectious from non-infectious fever. J Infect. 2010;60(6):409-416.
Kim MH, Lim G, Kang SY, et al. Utility of procalcitonin as an early diagnostic marker of bacteremia in patients with acute fever. Yonsei Med J. 2011;52(2):276-281.
Naito T, Mizooka M, Mitsumoto F, et al. Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study. BMJ Open. 2013;3(12):e003971.
Cunha BA. Fever of unknown origin (FUO): diagnostic importance of serum ferritin levels. Scand J Infect Dis. 2007;39(6-7):651-652.
Wright WF, Mulders-Manders CM, Auwaerter PG, et al. Fever of Unknown Origin (FUO) - A Call for New Research Standards and Updated Clinical Management. Am J Med. 2021.
Haidar G, Singh N. Fever of Unknown Origin. N Engl J Med. 2022;386(5):463-477.
