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A Diagnostic Tool for Identification of Etiologies of Fever of Unknown Origin in Adult Patients

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Summary

The diagnosis and treatment of fever of unknown origin (FUO) are huge challenges to clinicians. Separating the etiologies of FUO into infectious and non-infectious disease is conducive to clinical physicians not only on making decisions rapidly concerning the prescription of suitable antibiotics but also on further analysis of the final diagnosis. In order to develop and validate a diagnostic tool to efficiently distinguish the etiologies of adult FUO patients as infectious or non-infectious disease, FUO patients from the departments of infectious disease and internal medicine in three Chinese tertiary hospitals were enrolled retrospectively and prospectively. By using polynomial logistic regression analysis, the diagnostic formula and the associated scoring system were developed. The variables included in this diagnostic formula were from clinical evaluations and common laboratory examinations. The proposed tool could discriminate infectious and non-infectious causes of FUO with an area under receiver operating characteristic curve (AUC) of 0.83, sensitivity of 0.80 and specificity of 0.75. This diagnosis tool could predict the infectious and non-infectious causes of FUO in the validation cohort with an AUC of 0.79, sensitivity of 0.79 and specificity of 0.70. The results suggested that this diagnostic tool could be a reliable tool to discriminate between infectious and non-infectious causes of FUO.

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Author notes

  1. Both authors contributed equally to the work.

Authors and Affiliations

  1. Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Man-zhi Zhao, Ming-you Xing, Dong Xu, Zhu-hua Wu, Lin Zhu, Ji-ling Zhu, Cai-feng Zheng, Jun-ying Qi & Jian-xin Song

  2. Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Qiu-rong Ruan

  3. Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Sheng Wei

  4. Department of Internal Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Shi Liu

  5. Department of Infectious Diseases, the First Affiliated Hospital of Medical College of Zhengzhou University, Zhengzhou, 450052, China

    Zu-jiang Yu

Authors
  1. Man-zhi Zhao
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  2. Qiu-rong Ruan
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  3. Ming-you Xing
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  4. Sheng Wei
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  5. Dong Xu
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  6. Zhu-hua Wu
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  7. Lin Zhu
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  8. Ji-ling Zhu
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  9. Cai-feng Zheng
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  10. Shi Liu
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  11. Zu-jiang Yu
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  12. Jun-ying Qi
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  13. Jian-xin Song
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Corresponding author

Correspondence to Jian-xin Song.

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None of the other authors have any conflicts of interest to declare.

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Zhao, Mz., Ruan, Qr., Xing, My. et al. A Diagnostic Tool for Identification of Etiologies of Fever of Unknown Origin in Adult Patients. CURR MED SCI 39, 589–596 (2019). https://doi.org/10.1007/s11596-019-2078-3

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  • DOI: https://doi.org/10.1007/s11596-019-2078-3

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