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Key diagnostic characteristics of fever of unknown origin: A prospective multicenter study

Research Project

Project/Area Number 16K09257
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field General internal medicine(including psychosomatic medicine)
Research InstitutionJuntendo University

Principal Investigator

Naito Toshio  順天堂大学, 医学部, 教授 (10365570)

Co-Investigator(Kenkyū-buntansha) 古庄 憲浩  九州大学, 医学研究院, 共同研究員 (10346786)
大塚 文男  岡山大学, 医歯薬学総合研究科, 教授 (40362967)
舛形 尚  香川大学, 医学部附属病院, 教授 (70263910)
森田 浩之  岐阜大学, 大学院医学系研究科, 教授 (90252147)
Project Period (FY) 2016-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords不明熱 / 高齢者 / 赤沈 / 炎症マーカー / PET検査 / 血沈 / 高齢化 / 成人Still病 / 血管内リンパ腫 / 感染性心内膜炎 / 家族性地中海熱 / 膠原病 / ウィルス感染症 / 総合診療
Outline of Final Research Achievements

A total of 141 cases of FUO recruited from 16 hospitals affiliated with the Japanese Society of Hospital General Medicine.
The most frequent age group was 65-79 years old with a higher frequency of NIID as the cause of FUO. After a 6-month follow-up period, 21.3% of cases remained undiagnosed. Chi-square tests showed that the causative diseases for FUO were significantly correlated with age and prognosis. Between patients with and those without the final diagnosis, the performance of erythrocyte sedimentation rate test(ESR) was compared by logistic regression analysis, which revealed a significant difference (p = 0.041).
These results may provide clinicians key insights in management of FUO which permits the adequate treatments according to the causes of disease.

Academic Significance and Societal Importance of the Research Achievements

我々の研究により、赤沈、CRPや血清プロカルシトニンなどの炎症マーカーと、原因疾患、予後との関連を統計学的に解析し、その臨床的意義が明らかになった。さらには実際に不明熱患者を6ヵ月間経過観察することにより、不明熱患者の診療において真に想起すべき疾患、選択するべき検査を明らかになった。高齢化や医療体制の変化、検査の進歩などにより、不明熱の原因疾患は変遷していく。この変化を捉え、想起すべき疾患や診断に有用な検査を継続して集計・発表することは大変有意義である。この研究により不要な検査が減少し、医療費の削減に寄与すると思われる。

Report

(4 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (11 results)

All 2018 2016

All Journal Article (8 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 8 results,  Open Access: 8 results) Presentation (3 results) (of which Int'l Joint Research: 2 results,  Invited: 2 results)

  • [Journal Article] Useful Predictive Factors for Bacteremia among Outpatients with Pyelonephritis2018

    • Author(s)
      Nakamura Nobuhiro, Uehara Yuki, Fukui Sayato, Fujibayashi Kazutoshi, Yokokawa Hirohide, Naito Toshio
    • Journal Title

      Internal Medicine

      Volume: 57 Issue: 10 Pages: 1399-1403

    • DOI

      10.2169/internalmedicine.9222-17

    • NAID

      130006734382

    • ISSN
      0918-2918, 1349-7235
    • Year and Date
      2018-05-15
    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Dr. Stein’s Problem-Based Learning “I Can’t Walk Because of Fever and Physical Pain!”2018

    • Author(s)
      Naito T, Fukui-Watanabe Y, Uehara Y, Aoki M, Stein GH.
    • Journal Title

      Juntendo Medical Journal

      Volume: 64 Issue: 5 Pages: 338-343

    • DOI

      10.14789/jmj.2018.64.JMJ18-WN06

    • NAID

      130007535600

    • ISSN
      2187-9737, 2188-2126
    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Bacteraemia predictive factors among general medical inpatients: a retrospective cross-sectional survey in a Japanese university hospital.2016

    • Author(s)
      Fukui S, Uehara Y, Fujibayashi K, Takahashi O, Hisaoka T, Naito T.
    • Journal Title

      BMJ Open

      Volume: 6 Issue: 7 Pages: e010527-e010527

    • DOI

      10.1136/bmjopen-2015-010527

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] A case of infective endocarditis along with a ruptured valve caused by Streptococcus agalactiae in an immunocompetent man.2016

    • Author(s)
      Suzuki K, Hirai Y, Morita F, Uehara Y, Oshima H, Mitsuhashi K, Amano A, Naito T.
    • Journal Title

      IDCases

      Volume: 6 Pages: 94-96

    • DOI

      10.1016/j.idcr.2016.10.012

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Infective endocarditis and Sjegren's syndrome diagnosed simultaneously.2016

    • Author(s)
      Morita F, Hirai Y, Suzuki K, Uehara Y, Mitsuhashi K, Amano A, Naito T.
    • Journal Title

      IDCases

      Volume: 7 Pages: 6-8

    • DOI

      10.1016/j.idcr.2016.11.003

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prevalence of intestinal parasitic infections among school children in capital areas of the Democratic Republic of Sao Tome and Principe, West Africa.2016

    • Author(s)
      Liao CW, Fu CJ, Kao CY, Lee YL, Chen PC, Chuang TW, Naito T, Chou CM, Huang YC, Bonfim I, Fan CK.
    • Journal Title

      Afr Health Sci

      Volume: 16 Issue: 3 Pages: 690-697

    • DOI

      10.4314/ahs.v16i3.8

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] A Case of IgG4-Related Disease Admitted with CRP Elevation of Unknown Origin.2016

    • Author(s)
      Inui A, Naito T.
    • Journal Title

      Juntendo Medical Journal

      Volume: 62 Pages: 228-231

    • NAID

      130005277371

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Clinical Approach to Febrile Patients.2016

    • Author(s)
      Naito T.
    • Journal Title

      Juntendo Medical Journal

      Volume: 62 Pages: 224-227

    • NAID

      130005277374

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] Annual Meetings of JSHGM and FUO study2018

    • Author(s)
      Toshio Naito
    • Organizer
      Society of Hospital Medicine 2018 (Florida, USA)
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] Annual Meetings of JSHGM and FUO study2018

    • Author(s)
      内藤 俊夫
    • Organizer
      Society of Hospital Medicine
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] 【中間報告】不明熱の原因疾患・診断方法に関する多施設共同前向き研究(FUO study)2018

    • Author(s)
      種井 実佳, 内藤 俊夫, 古庄 憲浩, 田妻 進, 宮崎 英士, 鈴木 富雄, 西尾 健治, 大谷 寛, 森田 浩之, 林 純
    • Organizer
      第16回 日本病院総合診療医学会
    • Related Report
      2017 Research-status Report

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Published: 2016-04-21   Modified: 2020-03-30  

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