Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study

2014 Fiscal Year Final Research Report

• Project/Area Number: 25670359
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: Juntendo University
• Principal Investigator: NAITO Toshio 順天堂大学, 医学部, 准教授 (10365570)
• Co-Investigator(Kenkyū-buntansha): SENDA Shoichi 香川大学, 医学部附属病院, 名誉教授 (30145049) ; OTSUKA Fumio 岡山大学, 医歯学総合研究科, 教授 (40362967) ; UKIMURA Akira 大阪医科大学, 医学部, 教授 (50257862) ; MORITA Hiroyuki 岐阜大学, 医学研究科, 教授 (90252147)
• Project Period (FY): 2013-04-01 – 2015-03-31
• Keywords: 不明熱 / 総合診療 / 炎症マーカー / CRP / 赤沈 / プロカルシトニン

Outline of Final Research Achievements

A nationwide retrospective study including 17 hospitals affiliated with the Japanese Society of Hospital General Medicine was conducted.This study included 121 patients diagnosed with "classical FUO".
The causative disease was infectious diseases in 28 patients (23.1%), non-infectious inflammatory disease (NIID) in 37 patients (30.6%), malignancy in 13 patients (10.7%), other in 15 patients (12.4%) and unknown in 28 patients (23.1%). The rate of malignancy was significantly higher for lower WBC count (p=0.015). Among the patients with a higher WBC count, the rate of FUO due to NIID tended to be higher and the number of unknown cases tended to be lower. All FUO patients with malignancy showed an ESR of >40 mm/h. A normal ESR appeared to constitute powerful evidence for excluding a diagnosis of malignancy. The present study identified inflammatory markers that should be considered in the differential diagnosis of classical FUO, providing useful information for future diagnosis.

Free Research Field

総合診療、感染症