Objective To understand the clinical characteristics of patients with infective endocarditis(IE)whose primary symptom is fever of unknown origin(FUO),aiming to improve early recognition of this disease.Methods Clinical data were collected from patients diagnosed with IE at General Hospital of Ningxia Medical University between January 2023 and November 2023,who presented with FUO.A retrospective analysis was conducted on the patients'general information,initial diagnosis,laboratory test results,complications,and treatment outcomes.Results Among the 62 patients included in the study,a male-to-female ratio was 1.14∶1.The average age was(48.85±13.74)years,and the most prevalent age range was 41-64 years(42/62,67.7％).The maximum body temperature of the 62 patients fluctuated between 38.4-41.0℃,and all patients experienced recurrent fever for more than 3 weeks.Ten patients(10/62,16.1％)had predisposing factors such as previous cardiac surgery,and 22 patients(22/62,35.5％)had a history of underlying heart disease.The most common initial diagnosis was infectious fever(29/62,46.8％),followed by respiratory infections(16/62,25.8％).Blood cultures were positive in 74.2％(46/62)of the patients,with 35 cases(35/46,76.1％)being Gram-positive bacteria.Laboratory tests showed elevated white blood cell counts of＞9.50 × 109/L in 31 patients(31/62,50.0％),increased neutrophil percentage of＞75.0％in 43 patients(43/62,69.4％),decreased hemoglobin in 49 patients(49/62,79.0％),and increased procalcitonin in 52 patients(52/62,83.8％).Echocardiography detected vegetations in all 62 patients(100.0％,62/62),with the highest detection rate on the mitral valve(29/62,46.8％).Complications occurred in 51 patients(51/62,82.3％).All patients underwent intravenous antibiotic treatment,and 3 cases died.Conclusions For IE patients with FUO as the primary manifestation,clinical symptoms,signs,and laboratory results are often nonspecific.For patients with a history of cardiac surgery,interventional procedures,or underlying heart disease,IE should be highly suspected,and early echocardiography and blood culture tests should be conducted.The presence of complications such as heart failure,embolism,and glomerulonephritis in FUO patients may also serve as clues for diagnosing IE.
Fever of unkown originInfective endocarditisClinical characteristics
NETL
NSTL
万方数据
