Çocukluk Çağında Nedeni Bilinmeyen Ateş ile İzlenen Hastaların Klinik ve Laboratuvar Bulgularının Değerlendirilmesi

Abstract

Bayrak, S., Evaluation of Clinical and Laboratory Findings of Patients with Fever of Unknown Origin in Childhood, Hacettepe University Faculty of Medicine, Pediatrics Thesis. Ankara 2022. Fever of unknown origin (FUO) is a clinical presentation in which a wide variety of diseases take place in etiology, ranging from viral diseases that can heal on their own, to malignancies that can result in death if not treated. In this study, it was aimed to determine the common causes of FUO etiology in our country, to create a useful approach for diagnosis and treatment in new cases, and to increase the knowledge of physicians on this subject. In this study, the history and physical examination findings of the pediatric patients aged 1 month-18 years, who were followed up with the diagnosis of FUO in Hacettepe Ihsan Dogramacı Children's Hospital between January 1, 2014 and December 31, 2020, were examined. Data were analyzed retrospectively from patient files and hospital information management system. FUO criteria were accepted as a body temperature measurement of 3 38.3 °C at least once a day, lasting for at least 14 days, for which the cause of fever could not be determined by detailed history, physical examination findings and basic laboratory tests. Sixty nine patients were included in the study. Thirty nine (56.5%) of the patients were male and 30 (43.5%) were female. The age range of the patients ranged from 5 months to 17 years and 10 months, with a mean age of 4.7 years and a median age of 2.3 years. While 49 (71%) of the patients could be diagnosed, 20 (29%) could not be diagnosed. Infectious disease was found in 22 (31.9%) patients, rheumatological disease in 11 (15.9%) patients, malignancy in 9 (13%) patients, and other diseases in 7 (10.1%) patients among all patients. Age of undiagnosed patients; were smaller than the patients in the infectious diseases, rheumatological disease and malignancy groups. While the most common infectious disease is atypical pneumonia (6 patients), the most common viral agent among all infectious diseases is influenza A virus (atypical pneumonia in 2 patients, mixed viral infection in 1 patient, single agent in 1 patient), the most common bacterial agent Salmonella species (3 patients). At the end of the study, it was found that infections in the etiology of FUO were still in the first place and 29% of the patients could not be diagnosed despite the increase in diagnostic test possibilities over the years. Repeated history and physical examination, and first-line non-invasive diagnostic tests were found to be the most helpful tools in the diagnosis process.