• 대한한방소아과학회지
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• 제14권1호
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• pp.189-196
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• 2000

Recently, By the climatic change and increased resistance to antibiotics, diseases with atypical fever are increasing. FUO(Fever unknown origin) is defined' as fever persisting for $1{\sim}3weeks$ which origins are not found. through the reports of two clinical cases presenting FUO, I pretend to show the orient-medical and west-medical approachs to FUO.

• Clinical and Experimental Pediatrics
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• 제50권2호
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• pp.127-131
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• 2007

Fever of unknown origin (FUO) has been a convenient term used to classify patients who warrant a particular systemic approach to diagnostic evaluation and management. The greatest clinical concern in evaluating FUO is identifying patients whose fever has a serious or life-threatening cause when a delay in diagnosis could jeopardize successful intervention. Thorough history and complete physical examination are critical to uncover the etiologic diagnosis. Most cases of FUO in children are caused by atypical presentations of common diseases rather than by typical manifestations of rare disorders. Selection of diagnostic tests and speed of investigation should be guided by a knowledge of the disease severity, patient age, epidemiologic and geographic information, and any positive findings from a detailed history and physical examination. The three most common causes of FUO in children are infectious diseases, connective tissue diseases, and malignancy. In general, the prognosis of FUO in children is better than that of adults. Although the outcome is dependent on the primary disease process, fever abates spontaneously in most cases in whom the cause of fever remains unclear.

• Clinical and Experimental Pediatrics
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• 제60권3호
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• pp.77-85
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• 2017

Purpose: Fever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories. Methods: Among the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ${\geq}38.0^{\circ}C$ for longer than ${\geq}14days$ and failure to reach a diagnosis after one week of investigations were included. Results: Total 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%). Conclusion: Almost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases.

• 동의생리병리학회지
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• 제28권6호
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• pp.683-688
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• 2014

Fever of Unknown Origin(FUO) is defined as a temperature higher than 38.3'C that persists without diagnosis for at least 3 weeks despite appropriate investigation. The purpose of this study was to analyze the effectiveness of oriental medical treatment on the patient with FUO. We treated a female patient with FUO by oriental medical treatment with appropriate herbal medicine and balanced acupuncture. We prescribed Galgunhaegi-tang (Gegenjieji-tang) for 5 days and Handayeolso-tang(Handuoreshao-tang) for 9 days. At the same period, we also applied acupuncture and checked body temperature. In order to measure a pain of the patient, we used Visual Analogue Scale(VAS). It was found that Galgunhaegi-tang had little effect at this time, but the administration of Handayeolso-tang brought the positive effect on the patient. The body temperature of the patient was lowered and VAS score was reduced apparently after treatment. Handayeolso-tang might be used for relieving symptoms of FUO.

• 사상체질의학회지
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• 제19권2호
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• pp.223-229
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• 2007

1. Objectives FUO is defined as a temperature higher than $38.3^{\circ}C$ on several occasions and lasting longer than 3 weeks, with a diagnosis that remain uncertain after 1 week of investigation. Diagnosing the cause of FUO is particularly difficult. 2. Methods We have tried researching effect of herbal medicines(Kalkunhaeki - tang treatments) and Acupoint Injection to Taeumin FUO patient. 3. Results A Taeumin patient diagnosed to FUO was treated with Taeumin herbal medicines(kalkunhaeki - tang treatments) and change of patient's fever and general condition were improved. 4. Conclusions The constitutional treatment with Kalkunhaeki - tang may have an effect on management of FUO. So we report the healing process and results of this patient in this study.

• Journal of Yeungnam Medical Science
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• 제25권1호
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• pp.64-71
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• 2008

불명열을 규명하기 위한 과정은 여러 복잡한 검사와 평가를 필요로 하며 새로운 검사법의 개발로 그 접근법이 날로 발전하고 새로운 질병 양상이 밝혀지고 있다. 최근에는 PET 스켄이 도입되어 불명열의 선별 검사로서 그 효용성이 높은 것으로 입증되고 있다. 저자들은 전신 fusion PET/CT에서 일정한 양상으로 FDG의 섭취가 증가된 불명열 3례를 경험하고 보고하는 바이다; 3례 모두 대퇴골과 경골에 같은 분포와 양상의 섭취 증가를 보였으며, 골수 생검상, 2례에서 성숙한 림프구와 조직구의 침윤 및 점액성 변화를 보였고, 그 중 1예는 겉질뼈도 침범된 소견을 보였다. 환자들은 모두 수 주간 지속되는 호중구 감소와 상대적 림프구 증가증이 동반된 열이 있는 젊은 여성이었고, 자연적으로 완화되었다. 비록 연구 결과만으로 특정 질환을 분류할 수는 없었지만, 일련의 특정한 PET/CT 양상과 조직 소견은 질병의 원인과 관련 있을 것이고, 고전적 FUO와 관련하여 이러한 새로운 PET FDG 섭취 분포에 대한 연구가 필요할 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.683-686
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• 2014

Objective: The purpose of the study was to evaluate clinical value of dual-phase $^{18}F$-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO). Methods: PCT test and dual-phase $^{18}F$-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all $^{18}F$-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual-phase $^{18}F$-FDG SPECT and bacterial cultivation, regarded as a gold standard. Results: Among 50 patients, 34 demonstrated PCT ${\geq}0.5{\mu}g/L$. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase $^{18}F$-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up. Conclusion: Our study demonstrated that dual-phase $^{18}F$-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.

• 사상체질의학회지
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• 제22권4호
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• pp.124-129
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• 2010

1. Objectives The purpose of this case is to report the effects of Sibimijihwang-tang(十二味地黃湯) which is based on Sasang constitutional Medicine for Yin-Deficit Diurnal-Heat Symptomatology(陰虛午熱證) in Soyangin. 2. Methods We treated a Soyangin patients that had Fever Unknow Origin. We prescribed Sibimijihwang-tang(十二味地黃湯) for her physical symptoms. The improvement of her diseases was evaluated by her fever and other physical symptoms. 3. Results After the Sasang constitutional medication of Sibimijihwang-tang(十二味地黃湯) was given, the patient's fever and physical symptoms were improved. 4. Conclusions This case study show an efficient result of using Sibimijihwang-tang(十二味地黃湯) in the Yin-Deficit Diurnal-Heat Symptomatology(陰虛午熱證) of Soyangin.

• Nuclear Medicine and Molecular Imaging
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• 제42권1호
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• pp.79-80
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• 2008

Including malignancy, various disease can show abnormal uptake in bone marrow. We report a case of non-specific inflammatory FDG uptake in bone marrow mimicking malignancy. A 35-year old woman with fever of unknown origin (FUO) underwent $^{18}F$-FDG PET/CT to find out fever $^{18}F$-FDG and unknown malignancy. $^{18}F$-FDG was injected and imaged 1hr after injection with Discovery ST (GE, USA), $^{18}F$-FDG PET/CT whole body image showed abnormal uptake in lower extremities (Fig. 1). MRI and biopsy was also done in the sites of abnormal uptake. PET and MRI suspect malignancy (Fig. 2, 3), but biopsy result was non-specific inflammatory process (Fig. 4). The patient was improved her clinical condition after antibiotics therapy.

• Pediatric Infection and Vaccine
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• 제8권2호
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• pp.253-259
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• 2001

1972년에 Kikuchi씨에 의해 최초로 보고된 아급성 괴사성 림프선염은 30세 전 연령에서 주로 발병하고 여자에서 다소 높게 발생하는 역학적 특성이 있는 질환으로서 발열, 발진, 림프구감소 등의 임상증상이 동반되어 감염성 병원체에 의한 질환일 가능성을 추정하나 원인은 확인되지 않았다. 한편 Kikuchi씨 질환은 임상적으로 불명열에 준하는 장기간의 발열과 림프선 종창을 보이는 소견 이외에 특징적인 증상과 증세가 없고 진단을 위한 면역혈청학적 특이검사가 없어 진단이 매우 어려워 조기에 감염 질환, 자가면역성 질환, 교원성 질환, 림프종양질환과의 감별이 용이하지 않아 이 질환이 의심될 경우 조기에 림프절 생검을 통한 조직병리 소견으로 진단하여 불필요한 검사와 치료를 방지하는 것이 중요하다. 저자들은 기침, 객담, 경부 림프절 종창이 있으면서 발열이 30일 동안이나 지속되어 불명열 환자로 오인되었던 14세 된 남아에서 생검한 경부 림프절 조직에서 전형적인 아급성 괴사성 림프절염 소견을 확인하고, 동시에 동소 교잡법으로 EBV 잠복감염을 확인한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.