PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media279110ArticlesСтатьиFEVER OF UNKNOWN ORIGINЛИХОРАДКА НЕЯСНОГО ГЕНЕЗАMukhinNikolay AlekseevichМухинНиколай Алексеевич

ГБОУ ВПО Первый МГМУ им. И.М. Сеченова Минздравсоцразвития России

MukhinN AГБОУ ВПО Первый МГМУ им. И.М. Сеченова Минздравсоцразвития России151020111819NO19 (2011)№19 (2011)91424022023Copyright ©; 2011, Bionika MediaCopyright ©; 2011, ООО «Бионика Медиа»2011Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/279110

The article discusses the approaches to examination of patients with fever of unknown origin (FUO), which can masks life-threatening diseases (tuberculosis, malignancies, systemic diseases, etc.). The classification of FUO is presented; underlying causes and options for the clinical picture are considered. It is emphasized that FUO is one of the most topical problem of clinic of internal diseases, which requires not only improvement the management with application of new technologies, but also the cooperation of clinical centers, summarizing their experience in the multicenter clinical trials.

Обсуждаются подходы к обследованию больных лихорадкой неясного генеза (ЛНГ), за которой могут скрываться опасные для жизни заболевания (туберкулез, злокачественные опухоли, системные заболевания и т. д.). Представлена классификация ЛНГ, рассматриваются ее основные причины и варианты клинической картины. Подчеркивается, что ЛНГ остается одной из наиболее актуальных проблем клиники внутренних болезней, решение которой требует не только совершенствования тактики обследования с внедрением новых технологий, но и кооперации клинических центров, обобщения их опыта в рамках многоцентровых клинических исследований.

fever of unknown origintuberculosismalignanciessystemic diseasesлихорадка неясного генезатуберкулеззлокачественные опухолисистемные заболеванияGaeta GB, Fusco FM, Nardiello S. Fever of unknown origin: a systematic review of the literature for 1995-2004. Nucl Med Commun 2006;27(3):205-11.Petersdorf RG, Beeson P. 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;11:37.Сolpan A, Onguru P, Erbay A, et al. Fever of unknown origin: analysis of 71 consecutive cases. Am J Med Sci 2007;334(2):92-6.Mourad O, Palda V, Detsky AS. A comprehensive evidence-based approach to fever of unknown origin. Arch Intern Med 2003;163(5):545-51.Ma XJ, Wang AX, Deng GH, Sheng RY. A clinical review of 449 cases with fever of unknown origin. Zhonghua Nei Ke Za Zhi 2004;43(9):682-85.Molina-Gamboa J, Rivera-Morales I, Camacho-Mezquita E, Ponce-de-León S. The changing spectrum of fever of unknown origin: trends and comparison with previous series at the Salvador Zubirán National Institute of Nutrition. Rev Invest Clin 1994;46(3):177-85.de Kleijn EM, van der Meer JW. Fever of unknown origin (FUO): report on 53 patients in a Dutch university hospital. Neth J Med 1995;47(2):54-60.Liu KS, Sheng WH, Chen YC, et al. Fever of unknown origin: a retrospective study of 78 adult patients in Taiwan. J Microbiol Immunol Infect 2003;36(4):243-47.Shoji S, Imamura A, Imai Y, et al. Fever of unknown origin: a review of 80 patients from the Shin'etsu area of Japan from 1986-1992. Intern Med 1994;33(2):74-6.Barbado FJ, Vazquez JJ, Pena JM, et al. Fever of unknown origin: a survey on 133 patients. J Med 1984;15(3):185-92.Knockaert DC, Vanneste LJ, Bobbaers HJ. Fever of unknown origin in elderly patients. J Am Geriatr Soc 1993;41(11):1187-92.Борисов И.А., Давыдов В.М., Перов Ю.Л. и соавт. Структура патологии старческой почки и трудности ее диагностики // Тер. архив 1986. № 8. С. 37-45.High KP, Bradley SP, Gravenstein S, et al. Clinical practice guideline for the evaluation of fever and infection in older and adult residents of long-term care facilities: 2008 update by the Infectious Disease Society of America. Clin Infect Dis 2009;48:149-71.de Kleijn EM, Vandenbroucke JP, van der Meer JW. Fever of unknown origin (FUO). 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.Bofinger JJ, Schlossberg D. Fever of unknown origin caused by tuberculosis. Infect Dis Clin North Am 2007;21(4):947-62.Okada R, Yuzawa Y, Kawamura T, et al. Incidence of fever of unknown origin and subsequent antitubercular medications in hemodialysis patients: a two-year prospective study. Ren Fail 2009;31(10):863-68.Pottakkat B, Kumar A, Rastogi A, et al. Tuberculosis of the spleen as a cause of Fever of unknown origin and splenomegaly. Gut Liver 2010;4(1):94-7.Efstathiou SP, Pefanis AV, Tsiakou AG, et al. Fever of unknown origin: discrimination between infectious and non-infectious causes. Eur J Intern Med 2010;21(2):137-43.Hadda V, Khilnani G, Kedia S. Brucellosis presenting as pyrexia of unknown origin in an international traveller: a case report. Cases J 2009;2:7969.Roth AR, Basello GM. Approach to the adult patient with fever of unknown origin. Am Fam Phys 2003;68(11):2223-28.Hot A, Schmulewitz L, Viard JP, et al. Fever of unknown origin in HIV/AIDS patients. Infect Dis Clin North Am 2007;21(4):1013-32.Abellan-Martinez J, Guerra-Vales JM, Fernandez-Cotarelo MJ, Gonzalez-Alegre MT. Evolution of the incidence and aetiology of fever of unknown origin (FUO), and survival in HIV-infected patients after HAART (Highly Active Antiretroviral Therapy). Eur J Intern Med 2009;20(5):474-77.Cunha BA, Hage JE, Nouri Y. Recurrent fever of unknown origin (FUO): Aseptic meningitis, hepatosplenomegaly, pericarditis and a double quotidian fever due to juvenile rheumatoid arthritis (JRA). Heart Lung 2011 Mar 29 [Epub ahead of print].Mert A, Ozaras R, Tabak F, et al. Fever of unknown origin: a review of 20 patients with adult-onset Still's disease. Clin Rheumatol 2003;22(2):89-93.Vassilopoulos D, Sialevris K, Malahtari S, et al. Subacute thyroiditis presenting as fever of unknown origin in a patient with rheumatoid arthritis under etanercept treatment. J Clin Rheumatol 2010;16(2):88-9.Arnow PM, Flaherty JP. Fever of unknown origin. Lancet 1997;350:575-80.Hot A, Jaisson I, Girard C, et al. Yield of bone marrow examination in diagnosing the source of fever of unknown origin. Arch Intern Med 2009;169(21):2018-23.Meller J, Sahlmann CO, Scheel AK. 18F-FDG PET and PET/CT in fever of unknown origin. J Nucl Med 2007;48(1):35-45.Balink H, Collins J, Bruyn GA, Gemmel F. F-18 FDG PET/CT in the diagnosis of fever of unknown origin. Clin Nucl Med 2009;34(12):862-68.Kubota K, Nakamoto Y, Tamaki N, et al. FDG-PET for the diagnosis of fever of unknown origin: a Japanese multi-center study. Ann Nucl Med 2011;25(5):355-64.Bleeker-Rovers CP, de Kleijn EM, Corstens FH, et al. Clinical value of FDG PET in patients with fever of unknown origin and patients suspected of focal infection or inflammation. Eur J Nucl Med Mol Imaging 2004;31(1):29-37.