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Fieber ungeklärter Ursache

Fever of unknown origin

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Zusammenfassung

Protrahierte, trotz intensiver Diagnostik ungeklärte Fieberepisoden werden als Fieber ungeklärter Ursache („fever of unknown origin“, FUO) bezeichnet und stellen auch mit den modernen Verfahren der Labor- und Schnittbilddiagnostik noch eine besondere Herausforderung dar. Das FUO kann in verschiedene Kategorien eingeteilt werden (klassisches, nosokomiales, neutropenes, HIV-assoziiertes FUO), die sich an der besonderen klinischen und immunologischen Situation des Patienten orientieren. Als Ursache sind neben Infektionen und malignen Erkrankungen insbesondere entzündliche nichtinfektiöse Erkrankungen in Betracht zu ziehen, wobei bei einem großen Anteil der FUO-Patienten trotz ausgiebiger Diagnostik keine Ursache identifiziert werden kann. In der vorliegenden Übersichtsarbeit sollen die wichtigsten diagnostischen Maßnahmen bei der Abklärung des Patienten mit FUO diskutiert und therapeutische Aspekte erörtert werden.

Abstract

Fever of unknown origin (FUO) is defined as sustained unexplained fever despite intensive diagnostic evaluation and represents a particular diagnostic challenge. It can be classified into different categories, e.g. classical, nosocomial, neutropenic and HIV-associated FUO, which is based on the patient-specific clinical and immunological situation. Infections, malignant diseases and non-infectious inflammatory diseases have to be considered as the most important causes of FUO; however, no definitive diagnosis can be established in a substantial number of FUO patients despite an extensive diagnostic work-up. The present review focuses on the important diagnostic aspects as well as therapeutic options in FUO patients.

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Authors and Affiliations

  1. Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, Regensburg, Deutschland

    B. Salzberger, M. Müller-Schilling &  M. Fleck

  2. Klinik für Rheumatologie/Klinische Immunologie, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Deutschland

    M. Fleck

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  1. B. Salzberger
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  2. M. Müller-Schilling
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  3. M. Fleck
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Correspondence to M. Fleck.

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Salzberger, B., Müller-Schilling, M. & Fleck, M. Fieber ungeklärter Ursache. Z. Rheumatol. 72, 255–266 (2013). https://doi.org/10.1007/s00393-013-1164-3

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  • DOI: https://doi.org/10.1007/s00393-013-1164-3

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