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Article in Japanese

A study of diagnostic approach of 20 children with fever of unknown origin for imaging test and bone-marrow aspiration

Koo NAGASAWA1), Haruka HISHIKI1), Junko OIKAWA1), Sachiko NAITOH1), Naruhiko ISHIWADA2)

Twenty patients, who attended the Pediatric Department of Chiba University Hospital from June 2008 to May 2012, presented with fever of unknown origin and were considered retrospectively. Two cases had infectious diseases, 8 cases had rheumatic diseases, 1 case had neoplasms, 4 cases had other conditions. Five cases had no final diagnosis. Computed tomography was taken in 18 cases, 67Ga scintigraphy was performed in 13, and bone-marrow examination was carried out in 14. Three cases and two cases were diagnosed based on findings from computed tomography and bone-marrow examination, respectively. All cases of abnormal bone-marrow examination had cytopenia of two or more systems and their serum LDH were high (over 600 U/L). Therefore, adaptation of bone-marrow examination should be considered from blood test and serum LDH level. When you make a diagnosis of a patient with fever of unknown origin, repetition of routine examinations, such as blood tests and close patient observation, are important. Blind examinations should not be preferable.

Department of Pediatrics, Graduate School of Medicine, Chiba University

Key words
Received January 24, 2014
Accepted July 4, 2014

26 (3):387─393,2014