首页|Infectious causes of fever of unknown origin in developing countries:An international ID-IRI study

Infectious causes of fever of unknown origin in developing countries:An international ID-IRI study

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Background:Fever of unknown origin(FUO)in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of FUO.Methods:A multi-center study for infectious causes of FUO in lower middle-income countries(LMIC)and low-income countries(LIC)was conducted between January 1,2018 and January 1,2023.In total,15 participating centers from seven different countries provided the data,which were collected through the Infectious Diseases-International Research Initiative platform.Only adult patients with confirmed infection as the cause of FUO were included in the study.The severity parameters were quick Sequential Organ Failure Assessment(qSOFA)≥2,intensive care unit(ICU)admission,vasopressor use,and invasive mechanical ventilation(IMV).Results:A total of 160 patients with infectious FUO were included in the study.Overall,148(92.5％)patients had community-acquired infections and 12(7.5％)had hospital-acquired infections.The most common infec-tious syndromes were tuberculosis(TB)(n=27,16.9％),infective endocarditis(n=25,15.6％),malaria(n=21,13.1％),brucellosis(n=15,9.4％),and typhoid fever(n=9,5.6％).Plasmodium falciparum,Mycobacterium tubercu-losis,Brucellae,Staphylococcus aureus,Salmonella typhi,and Rickettsiae were the leading infectious agents in this study.A total of 56(35.0％)cases had invasive procedures for diagnosis.The mean qSOFA score was 0.76±0.94{median(interquartile range[IQR]):0(0-1)}.ICU admission(n=26,16.2％),vasopressor use(n=14,8.8％),and IMV(n=10,6.3％)were not rare.Overall,38(23.8％)patients had at least one of the severity parameters.The mortality rate was 15(9.4％),and the mortality was attributable to the infection causing FUO in 12(7.5％)patients.Conclusions:In LMIC and LIC,tuberculosis and cardiac infections were the most severe and the leading infections causing FUO.

Developing countriesFever of unknown originInfection

Hakan Erdem、Jaffar A.Al-Tawfiq、Maha Abid、Wissal Ben Yahia、George Akafity、Manar Ezzelarab Ramadan、Fatma Amer、Amani El-Kholy、Atousa Hakamifard、Bilal Ahmad Rahimi、Farouq Dayyab、Hulya Caskurlu、Reham Khedr、Muhammad Tahir、Lysien Zambrano、Mumtaz Ali Khan、Aun Raza、Nagwa Mostafa El-Sayed、Magdalena Baymakova、Aysun Yalci、Yasemin Cag、Umran Elbahr、Aamer Ikram

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Department of Infectious Diseases & Clinical Microbiology,Gulhane School of Medicine,Turkish Health Sciences University,Ankara,Turkey

Specialty Internal Medicine and Quality and Patient Safety Department Johns Hopkins Aramco Healthcare,Dhahran,Saudi Arabia

Division of Infectious Diseases,Indiana University School of Medicine,Indianapolis,IN,USA

Department of Infectious Diseases,Farhat Hached University Hospital,Ibn El Jazzar Medical School,University of Sousse,Sousse,Tunisia

Internal Medicine Department,Farhat Hached University Hospital,Ibn El Jazzar Medical School,University of Sousse,Sousse,Tunisia

Cape Coast Teaching Hospital,Cape Coast,Ghana

Medical Parasitology,Faculty of Medicine,Suez University,Suez,Egypt

Department of Medical Microbiology and Immunology,Faculty of Medicine,Zagazig University,Zagazig,Egypt

Department of Clinical Pathology,Faculty of Medicine,Cairo University,Giza,Egypt

Department of Infectious Diseases,School of Medicine,Isfahan University of Medical Sciences,Isfahan,Iran

Department of Infectious Diseases,Kandahar University Medical Faculty,Teaching Hospital Kandahar,Afghanistan

Department of Infectious Diseases,Mohammed Bn Khalifa Bn Salman Alkhalifa Specialist Cardiac Center,Awali,Bahrain

Department of Infectious Diseases and Clinical Microbiology,Faculty of Medicine,Istanbul Medeniyet University,Istanbul,Turkey

Department of Pediatric Oncology,National Cancer Institute-Cairo University,Children Cancer Hospital Egypt,Cairo,Egypt

Department of Medicine,Federal General Hospital,Islamabad,Pakistan

Institute for Research in Medical Sciences and Right to Health(ICIMEDES),Scientific Research Unit(UIC),Faculty of Medical Sciences(FCM),National Autonomous University of Honduras(UNAH),Tegucigalpa,Honduras

National Institute of Health,Islamabad,Pakistan

Shaukat Khanum Memorial Cancer Hospital and Research Center,Lahore,Pakistan

Medical Parasitology Department,Research Institute of Ophthalmology,Giza,Egypt

Department of Infectious Diseases,Military Medical Academy,Sofia,Bulgaria

Department of Infectious Diseases,Bahrain Oncology Center,King Hamad University Hospital,Al Muharraq,Bahrain

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2024

10.1016/j.jointm.2023.07.004

重症医学(英文)

重症医学(英文)

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年,卷(期)：2024.4(1)
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