title: Recent trends in the distribution of causative diseases of fever of unknown origin.
abstract: Fever of unknown origin is a challenging diagnostic problem and the aim of this research was to analyze trends in the distribution of its causative diseases. This retrospective study makes a comparison between two different clinical series of patients from two different periods: 227 from period 1 (1998-2002) and 602 from period 2 (2008-2012). There were fewer infections (31.72% vs.16.45%) and more miscellaneous causes (5.29% vs. 13.12%) in the period 2 series, whereas no significant differences in autoimmune diseases, malignancies and undiagnosed cases were found. Adult onset Still's disease and lymphoma occupied the largest proportion in autoimmune diseases (75.00%) and malignancies (89.81%), respectively. Interestingly, the autoimmune diseases group, instead of infections, was found to be the leading category of the causative diseases in fever of unknown origin, which is contrary to previous reports. Further, adult onset Still's disease and lymphoma were suggested to be valued more highly in view of the large and rising proportions found in this study. These trends could support the diagnosis and treatment of fever of unknown origin better in the future.
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Shang
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Libo
authors.initials: L
authors.lastname: Yan
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Lingyao
authors.initials: L
authors.lastname: Du
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Lingbo
authors.initials: L
authors.lastname: Liang
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Qiaoling
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liang
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China. pangbailang@163.com.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China. pangbailang@163.com.
authors.forename: Lang
authors.initials: L
authors.lastname: Bai
authors.affiliation: Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, 610041, Chengdu, Sichuan, China. htang6198@hotmail.com.|Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China. htang6198@hotmail.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015984:Causality; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D016706:Still's Disease, Adult-Onset / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: Adult-onset Still’s disease; Autoimmune diseases; Fever of unknown origin; Infections; Lymphoma