慢性透析患者の不明熱に関する検討

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  • Study of fever of unknown origin in patients on maintenance dialysis.

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From 1976 to 1989, we experienced 55 episodes of diagnosed fever of unknown origin (FUO) in 36 dialysis patients. Underlying causes of FUO were infection (18 episodes), collagen disease (1), and unknown (36). Infection included 10 episodes of tuberculosis, the most common cause of FUO, and 9 of the tuberculosis episodes were extrapulmonary. Thirty-one episodes (56.4%) of FUO appeared within the first year of maintenance dialysis. Thirteen episodes (28.9%) did not show leukocytosis or positive response to CRP in laboratory findings. Though the pattern of fever was intermittent or remittent, there was no pattern characteristic of any particular disease. We believe that some episodes involving fever below 33°C may indicate a disease which requires aggressive treatment. We suggest the immediate trial of antituberculosis therapy when antibiotic therapy is ineffective.

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