[感染和发烧]

IF 0.9 4区 医学 Q4 RHEUMATOLOGY
Zeitschrift fur Rheumatologie Pub Date : 2024-06-01 Epub Date: 2024-04-29 DOI:10.1007/s00393-024-01503-0
Stefan Schmiedel
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引用次数: 0

摘要

发热可由感染性或非感染性原因引起,是机体对外源性或内源性热原的自然反应。实验室检查包括全血细胞计数、血细胞差计数、C 反应蛋白、红细胞沉降率和降钙素原,但这些检查的敏感性和特异性不足以明确检测或排除发热的感染(细菌、病毒、寄生虫)原因。当怀疑是菌血症或败血症时,应进行血液培养。感染时不一定会发热,也可能不发热,尤其是老年患者和免疫力低下的患者。如果怀疑发烧,应测量核心体温,如直肠、口腔或侵入性体温。根据临床情况,急性发热最有可能的原因是感染,因此必须排除感染因素。对长期发热(不明原因发热,FUO)的调查可能很复杂,首先应排除一些感染性疾病,而综合征分类通常有助于明确发热的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Infections and fever].

Fever can be due to infectious or noninfectious causes and results from the body's natural response to exogenous or endogenous pyrogens. Laboratory tests including complete blood count, differential blood count, C‑reactive protein, erythrocyte sedimentation rate and procalcitonin do not have sufficient sensitivity and specificity to definitively detect or rule out an infectious (bacterial, viral, parasitic) cause of fever. Blood cultures should be carried out when bacteremic or septic illnesses are suspected. Fever is not always present in infections and can be absent, especially in older and immunocompromised patients. If fever is suspected, core temperatures should be taken, e.g., rectally, orally or invasively. Depending on the clinical situation, infectious causes must be excluded as the most likely cause of an acutely occurring fever. The investigation of long-standing fever (fever of unknown origin, FUO) can be complex and some infectious diseases should first be ruled out, whereby a syndromic classification often helps to clarify the cause of the fever.

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来源期刊
Zeitschrift fur Rheumatologie
Zeitschrift fur Rheumatologie 医学-风湿病学
CiteScore
2.20
自引率
20.00%
发文量
150
审稿时长
6-12 weeks
期刊介绍: Die Zeitschrift für Rheumatologie ist ein international angesehenes Publikationsorgan und dient der Fortbildung von niedergelassenen und in der Klinik tätigen Rheumatologen. Die Zeitschrift widmet sich allen Aspekten der klinischen Rheumatologie, der Therapie rheumatischer Erkrankungen sowie der rheumatologischen Grundlagenforschung. Umfassende Übersichtsarbeiten zu einem aktuellen Schwerpunktthema sind das Kernstück jeder Ausgabe. Im Mittelpunkt steht dabei gesichertes Wissen zu Diagnostik und Therapie mit hoher Relevanz für die tägliche Arbeit – der Leser erhält konkrete Handlungsempfehlungen. Frei eingereichte Originalien ermöglichen die Präsentation wichtiger klinischer Studien und dienen dem wissenschaftlichen Austausch.
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