摘要
Abstract
Objective To retrospectively analyze the clinical features of bloodstream infection (BSI) in patients with fever of unknown origin (FUO) in order to benefit clinical diagnosis and treatment of this disease.Methods From Xuanwu Hospital Capital Medical University,we enrolled 300 FUO inpatients who received treatment from 2012 to 2015.They underwent blood culture,and were identified with positive results after excluding contamination during the testing.According to the results of tests and the response to treatments,the results of blood culture was useful for diagnosis and treatment.Of the 300 FUO cases,22 were found with BSI.According to the BSI criteria,the patients identified with infectious endocarditis (IE) were assigned to the IE group (10 cases) and those without IE were assigned to non-IE group (12 cases).We compared the clinical data,and laboratory findings〔white blood count (WBC),platelet count (PLT),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),and procalcitonin (PCT)〕 between the two groups and analyzed the pathogenic bacterium's type and characteristics,results of antimicrobial susceptibility tests,and imagining (CT and echocardiography) findings of the BSI patients.Results The gender and course of disease did not differ significantly between IE patients and non-IE patients (P>0.05).Compared with non-IE patients,IE patients were younger (P<0.05).But both groups had similar distribution of sex and course of fever,and similar levels of WBC,PLT,ESR,CRP and PCT (P>0.05).Results of blood culture showed that,Streptococcus was the pathogenic bacterium for IE group,which was susceptible to common antibiotics;Staphylococcus,Brucella,Escherichia coli,Mycobacterium and Candida were the pathogenic bacteria for non-IE group.All the IE patients were found with valvular vegetations by echocardiography. Some non-IE patients' foci of infection could be identified by screening such as CT scan.Conclusion A FUO patient may be identified with IE if he has elevated ESR and CRP,normal PCT,plus Streptococcus as the pathogenic bacterium.For most of FUO patients without IE,imaging examination is a good method for detecting the foci of infection.关键词
不明原因发热/血流感染/生物学标记Key words
Fever of unknown origin/Bloodstream infection/Biological markers分类
医药卫生
