Nedeni Bilinmeyen Ateş

Klasik nedeni bilinmeyen ateş (NBA) birden fazla ölçümde 38,3 ºC'yi geçen, 3 haftadan uzun süredir devam eden ve bir haftalık hastanede yatarak araştırılmasına rağmen tanı konamayan ateşi olan olgular şeklinde tanımlanır. NBA olgusunun etyolojik araştırmasında öncelikle ayrıntılı anamnez ve fizik muayene yapılmalıdır. Daha sonra laboratuvar tetkikleri, görüntüleme yöntemleri ve biyopsi gibi invaziv işlemlerle tanıya ulaşılmaya çalışılır. NBA'ın en sık etyolojileri genellikle enfeksiyon hastalıkları, malign hastalıklar, enfeksiyon dışı inflamatuar hastalıklar, diğer tanılar ve tanı koyulamayanlar olmak üzere beş grup altında toplanmıştır. Enfeksiyöz nedenlerinden en sık bildirilenler apse, tüberküloz, infektif endokardit ve brusellozdur. Enfeksiyon dışı inflamatuar hastalıklardan en sık erişkin Still hastalığı ve malignitelerden en sık lenfomalar bildirilmiştir. Bu yazıda klasik NBA olgularına tanısal yaklaşım ve NBA'nın sık bildirilen etyolojileri tartışılmıştır.

Anahtar Kelimeler:

Nedeni bilinmeyen ateş, ateş; tüberküloz; lenfoma

Fever of Unknown Origin

Classic fever of unknown origin (FUO) is defined as the occurrence of a body temperature greater than 38.3°C on several occasions; a duration of fever greater than three weeks; and failure to reach a diagnosis despite one week of inpatient investigation. Etiologic assessment of FUO cases should primarily include a detailed history and physical examination. Laboratory tests, imaging techniques, and invasive procedures such as biopsy are then performed to achieve a diagnosis. Most etiologies of FUO are categorized into the following five groups: infections, malignancies, noninfectious inflammatory diseases, miscellaneous causes, and undiagnosed. The most commonly reported infectious disease etiologies were abscess, tuberculosis, endocarditis, and brucellosis. Adult Still's disease was reported as the most common noninfectious inflammatory disease and lymphoma was the most common malignancy. This review discusses the diagnostic approaches taken for cases of classic FUO and commonly reported etiologies of FUO.

Keywords:

Fever of unknown origin, fever; tuberculosis; lymphoma,

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