Fever of unknown origin FUO

Fever of unknown origin FUO PowerPoint PPT Presentation


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?????. FUO ????? ???? ????? ???? ???????? ???? ??? ????? ?????? ???????? ?????? ??? self-limited, ??????? ???? ????? ????? ???? ?????? ????.Petersdorf

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1. ??? ????? ???? ????? Fever of unknown origin (FUO) ?"? ??? ????? ??? ???? ????? ????? ?????? ?', ????? ?????? ?? ???? ?"? ??????? ??????? ?????? ?"? ????? ?? ????? ?????, ???? ????? ?? ?????. ????? ????? ??"? ???? ????? ????????? ??????? ??????? ????? ?????, ???? ????? ?????? ?? ????????? ????????, ?? ??????????????, ?? ????? ????? ??? ????? ?????. ?? ?? ???? ?????? ???? ?? ????? ????? ????. ?????? ????? ????? ?????? ?? ??? ?????? ??? ?????? ?? FUO or PUO. ?? ?? ?????? ????????, ?????? ?????? ??? 1-2 ????? ???"? ???????????. ?????? ????? ? 200 ????? ? FUO??? ????? ??? ????? ?? ?????????, ?????? ????? ???? ?? FUO ???? ???????? ??? ???? ?????? ?????? ???????.?? ????? ?????, ???? ????? ?? ?????. ????? ????? ??"? ???? ????? ????????? ??????? ??????? ????? ?????, ???? ????? ?????? ?? ????????? ????????, ?? ??????????????, ?? ????? ????? ??? ????? ?????. ?? ?? ???? ?????? ???? ?? ????? ????? ????. ?????? ????? ????? ?????? ?? ??? ?????? ??? ?????? ?? FUO or PUO. ?? ?? ?????? ????????, ?????? ?????? ??? 1-2 ????? ???"? ???????????. ?????? ????? ? 200 ????? ? FUO??? ????? ??? ????? ?? ?????????, ?????? ????? ???? ?? FUO ???? ???????? ??? ???? ?????? ?????? ???????.

2. ????? FUO ????? ???? ????? ???? ???????? ???? ??? ????? ?????? ???????? ?????? ??? self-limited, ??????? ???? ????? ????? ???? ?????? ????. Petersdorf & Beeson ? –1961: ?????? ???????: ???? ?????? ??? 3 ?????? ??? ??? 38.30 ????? ??' ????? ???? ????? ???? ???? ?? ???? ?????? ????"? FUO ????? ???? ????? ???? ???????? ???? ??? ????? ?????? ???????? ?????? ??? self-limited, ??????? ???? ????? ????? ???? ?????? ????. ???? ?????? ?? ???, ???? ????? ?? ?? ???? ??????, ????? ???? – ?? ?? ????? ??????, ?? ?? ???? ????? (?????? ??, ??????, ????? ????? ?? ?????), ????? ??? ?????. ??????? FUO ????? ??? ?????? ?????. Petersdorf & Beeson ?????? FUO ???? ????? ??? 3 ??????, ??? 38.3 ????? ????? ???? ???? ?? ???? ?????? ????"?. ?? ??, ??? ???? ?? ????? ?? ??? ????? ????? ?? ????? (?? ????????, ?????????, ?????????).FUO ????? ???? ????? ???? ???????? ???? ??? ????? ?????? ???????? ?????? ??? self-limited, ??????? ???? ????? ????? ???? ?????? ????. ???? ?????? ?? ???, ???? ????? ?? ?? ???? ??????, ????? ???? – ?? ?? ????? ??????, ?? ?? ???? ????? (?????? ??, ??????, ????? ????? ?? ?????), ????? ??? ?????. ??????? FUO ????? ??? ?????? ?????. Petersdorf & Beeson ?????? FUO ???? ????? ??? 3 ??????, ??? 38.3 ????? ????? ???? ???? ?? ???? ?????? ????"?. ?? ??, ??? ???? ?? ????? ?? ??? ????? ????? ?? ????? (?? ????????, ?????????, ?????????).

3. ????? (????) 1992, Petersdorf revised: ???? ?????? ??? 3 ?????? ??? ??? 38.30 ????? ??' ????? ???? ????? ???? ???? ?? ???? ?????? (??? ????? ????"?) ???????? ??????? ?????? ????? ????????: FUO ????? ????- Neutropenic FUO FUO ????? HIV FUO ??????????? FUO ?????? FUO ??????? Unexplained Fever ?-1992 ???? ??????? ?????? – ??? ?????? ???? ?????, ??? ?????? ?????? self limited ??? ?????, ??? ????? ???????? (????? ?????? ??? ????????). FUO (?????) ?? ???? ????? ??? ?????. ???????? ??????? Neutropenic FUO – ????? ????. FUO ????? HIV. FUO ??????????? (????? ??? ??????). FUO ??????. FUO ???????. Unexplained fever – ???? ??? ????? ???? ????? ??? ????. ????? 3 ?????? ??????? ??????? ?? ???????? ??????, ????? ???????? ??????? ?????? ????? ?????? ???????? ??????? ?????? ???? ?????? ??? ?????? ?????? ????? ??????? ?"? ???????? ????.?-1992 ???? ??????? ?????? – ??? ?????? ???? ?????, ??? ?????? ?????? self limited ??? ?????, ??? ????? ???????? (????? ?????? ??? ????????). FUO (?????) ?? ???? ????? ??? ?????. ???????? ??????? Neutropenic FUO – ????? ????. FUO ????? HIV. FUO ??????????? (????? ??? ??????). FUO ??????. FUO ???????. Unexplained fever – ???? ??? ????? ???? ????? ??? ????. ????? 3 ?????? ??????? ??????? ?? ???????? ??????, ????? ???????? ??????? ?????? ????? ?????? ???????? ??????? ?????? ???? ?????? ??? ?????? ?????? ????? ??????? ?"? ???????? ????.

4. ????? FUO ??? Durack & Street (1991) ????? - ??? ??? 3 ??????, ???? ???? ?? ???? ?????? (????? / ?????), ????? ???? ????????, ?????????, ????? ???????. HIV – ??? ??? 3 ?????? ??????, ???? ????? ???? ???????, ????????? – ????? ?? ?-3 ??? ?????, ???? ???? ????? ????, ???-?????. ???? ?????? ???? – ???? 3 ???? ?????? septic thrombophlebitis, c. Difficile ????? pseudomembranous colitis.????? - ??? ??? 3 ??????, ???? ???? ?? ???? ?????? (????? / ?????), ????? ???? ????????, ?????????, ????? ???????. HIV – ??? ??? 3 ?????? ??????, ???? ????? ???? ???????, ????????? – ????? ?? ?-3 ??? ?????, ???? ???? ????? ????, ???-?????. ???? ?????? ???? – ???? 3 ???? ?????? septic thrombophlebitis, c. Difficile ????? pseudomembranous colitis.

5. ?????? (?????? ??????) ?????? ?????, ?????? ????? ?? ?????? ? FUO ??? ???????? ????? ????? ?? ??? ????? ?????. ??????? 22-26% ????? ??????? ????? ??????? 24% ??????? 3% ??? ??????? 2% Factitious fever -2% ??? ????? 10-25% , ????? ??????. ??? ????? ????? ???? ????????? ???? ????? ??? ????? ?????? ??????. ?? ???????? ??? ????? ??????????????????. ????? ?-FUO ?? ????? ?? ????? – ??????? ??????? ?????? 25%, ????? ??????? ????? ??????? (25%), ??????? (3%) – ????? ??? ????? ???????, ????? ???????? ???????, factitious fever – ???? ????? ???? ???? ?????, ??? ????? (10-25%) – ??? ????? ????? ??????? ??? ?????.????? ?-FUO ?? ????? ?? ????? – ??????? ??????? ?????? 25%, ????? ??????? ????? ??????? (25%), ??????? (3%) – ????? ??? ????? ???????, ????? ???????? ???????, factitious fever – ???? ????? ???? ???? ?????, ??? ????? (10-25%) – ??? ????? ????? ??????? ??? ?????.

6. ???? ???????? ???????? ?-FUO ??? ???? ????? ?????? ???????. ?????????? ?? ????? ????????'. ??? ????? ?? ?????? ????? ????? ?? ???? ??? ???????, ???????, ????? ????? ????? ?????. ???? ????? ?????? ?? ???????? ?? PM – ????? ?????.???? ???????? ???????? ?-FUO ??? ???? ????? ?????? ???????. ?????????? ?? ????? ????????'. ??? ????? ?? ?????? ????? ????? ?? ???? ??? ???????, ???????, ????? ????? ????? ?????. ???? ????? ?????? ?? ???????? ?? PM – ????? ?????.

7. ?????? (?????? ??????)-???? ??????? ????? ??????? ???????? ??????? ?????? ?????? FUO. ???? ????? ???? ?????? ?????? ?? FUO SLE ???? ??? ????? ????, ?????, ??? ??????? ?? ?????? ???????, ???? ????? ???? ?????? ?? FUO. ??????, ??????????? ?????? ?"???", ?? ??? ??????? "?????", ????? ?????? ??????? (Q fever, bartonella quintana ), ?????? HACEK ??? ??? ?????? ??????? ?????????? . ?????, ?????? ????? ???????? ????? ??? ??? ????? ?????? ???????, ??????? ????? ??? ??????? ????? ?- HIV, ???? Lyme , ?????? Sweet ???'. ?? ?????? ??? ??????? ??? ?? ???? ???? Drug fever, ??? ????? ???? ?????? ????????. FUO ??? ?????? ?????? ????? ??????. ????? ?????? ???? ?????? (RF). ????? – ???? ?????? ????? ??? ??????? ????????. ??????????? – ???? ????? ?? ????. ????? ?? ??????? – ???? ??? ?-FUO. ???? ???? ???????? ???????, ???? ?????? ????????, ?????????, ??????, ???? ????? (????? ?? ??????? – ??????). ????? ?????. ???? ???? ????? ?????? ???????, ????? (?????????), ?????, ???????, ?????? ?-factitious. ?????? ?? ??"? ????? ?????? ??????? ?? ????? ?? ?????. ???? ???? ????? ????? ?????? ?? ????? ?? ???? ?????? ?? ?????? ?? ????? ???? – ??? ??? ???? ????? ?? ?????? ?? ????? ??????FUO ??? ?????? ?????? ????? ??????. ????? ?????? ???? ?????? (RF). ????? – ???? ?????? ????? ??? ??????? ????????. ??????????? – ???? ????? ?? ????. ????? ?? ??????? – ???? ??? ?-FUO. ???? ???? ???????? ???????, ???? ?????? ????????, ?????????, ??????, ???? ????? (????? ?? ??????? – ??????). ????? ?????. ???? ???? ????? ?????? ???????, ????? (?????????), ?????, ???????, ?????? ?-factitious. ?????? ?? ??"? ????? ?????? ??????? ?? ????? ?? ?????. ???? ???? ????? ????? ?????? ?? ????? ?? ???? ?????? ?? ?????? ?? ????? ???? – ??? ??? ???? ????? ?? ?????? ?? ????? ??????

8. ?????? ??? "????" ???? ?????? FUO ?? ????? ?????? ?????: ??????? ?????? (??????) ?????? ????? ?????? ??????? ????? ????? ???????? ??????? ?????? ?? ?????? ?????? ????? ????? ????????? ????? ????? ???????, ??? ???? ?????? (?????? ???? ????? ??????) ??? 19 ???? ?????? ?????? ???????! ??? ?? ??, ? - 10-25% ???? ?????? ??? ????? . ?? ?????: ?????? ?- FUO ?? ??"? ????? ?????? ??? ?????? ?? ????? ?????? ???? ???? ????? ?????? !

9. ??????? ?????? ?? ????? ?? ??????, ??????????, ????, ????? ????????, ????? ????? ???? (???? ???????), ????? ???????, ????? ????????, ?????? ????? ??? ??????. ??????? ?????? ??? ??? ?????? ???? ???????: ???????? (???? ?????) FMF ?????? ???????? ????? (?????) Psittacosis (?????) ?????? (Drug fever ) ?????? ??? ? ????? ???? ????? ?????? ????: ?????, ???? ??? ???,???? ??????, ??????????, ?????? ????? ????? ???????? ? FUO ????????: ?? ????? ?? ??????, ??????????, ????, ????? ????????, ????? ????? ???? (???? ???????), ????? ???????, ????? ????????, ?????? ????? ??? ??????. ??????? ?????? ??? ??? ?????? ???? ???????: ???????? (???? ?????) FMF ?????? ???????? ????? (?????) Psittacosis (?????) ?????? (Drug fever) ?????? ??? ? ????? ???? ????? ?????? ????: ?????, ???? ??? ???,???? ??????, ??????????, ?????? ????? ????? ???????? ? FUO ?? ???? ??????: "?? ?????? ?????? ????? ?????? FUO?" - CT ???. ????? ??? ??????, ??????????????, ????????? ?????? ??. ????????: ?? ????? ?? ??????, ??????????, ????, ????? ????????, ????? ????? ???? (???? ???????), ????? ???????, ????? ????????, ?????? ????? ??? ??????. ??????? ?????? ??? ??? ?????? ???? ???????: ???????? (???? ?????) FMF ?????? ???????? ????? (?????) Psittacosis (?????) ?????? (Drug fever) ?????? ??? ? ????? ???? ????? ?????? ????: ?????, ???? ??? ???,???? ??????, ??????????, ?????? ????? ????? ???????? ? FUO ?? ???? ??????: "?? ?????? ?????? ????? ?????? FUO?" - CT ???. ????? ??? ??????, ??????????????, ????????? ?????? ??.

10. ????? ?????? ????? ??????? ?? ????? ???? (???????????) ???? ????????????? (?????) ????? ?/?? ?????? ???? ???????? (GCA ) ????? ?????? ???? (??????? ?????) ????????????? ?????? (???? Whipple ) ???????????? ??? ?????, ?? ????? ???? ???????? ???? ???????, ????? ??????. ?????? ??????? ????? ????? ?-FUO: ????? ??????? ?? ????? ???? (???????????) ???? ????????????? (?????). ????? ?/?? ?????? ???? ???????? (GCA – temporal arteritis ) ????? ?????? ???? (??????? ?????) ????????????? ?????? (???? Whipple ) ???????????? ??? ?????, ?? ????? ???? ???????? ???? ???????, ????? ??????.?????? ??????? ????? ????? ?-FUO: ????? ??????? ?? ????? ???? (???????????) ???? ????????????? (?????). ????? ?/?? ?????? ???? ???????? (GCA – temporal arteritis ) ????? ?????? ???? (??????? ?????) ????????????? ?????? (???? Whipple ) ???????????? ??? ?????, ?? ????? ???? ???????? ???? ???????, ????? ??????.

11. ???????? ??????? ????? ????? ????? ????? ????? ????? ?????? ??? ????????, ??? ????? ?????? ?? FUO, ???? ????, ????? ????, ???? ???? ?? ???? ??????. ????? ?? ??? ?????? ?????? ?????? :Pel-Ebstein ????? ????'???, FMF, ?????, cyclic neutropenia, ??????. ?????“B"(???, ????? ????,????? ????, ???) ?????????, ?? ???? ???????. ????????? ????? ???? (?? ?????) ????? ??????: ???????, ????????????, ???????, ?????????, ??????????, ??? ??????, ??? ????????, ?- Factitious fever ?????? ?Naproxen : ???? ??? ?????? ???? ?-1984 ???? ???? ??? ????? ?????? ???? ???? ????? ??? ?????? ?????. ????? ???? ????? ?? ????? Still. FUO ???? ????: ??????? ?????? ????? (?? ?-5% ????? ??????? ) ????????? B-symptoms – ????? ????, ???? ???? ???? ????????? ????'??? ?? ?? ???????? (??????? ???'). ???????? – ????? ?? ???????, ????????????, ???????, ?????????, ??????????. ???? ?? ??? ???? ??? ???? ????? – ???? ????? ??????? ?-factitious fever/ FUO ???? ???? – ???? ????????? ???? ???????? ?????? ?????, ?? ??? 5% ?? ??????? ??? ?????? ????? ????.????????? B-symptoms – ????? ????, ???? ???? ???? ????????? ????'??? ?? ?? ???????? (??????? ???'). ???????? – ????? ?? ???????, ????????????, ???????, ?????????, ??????????. ???? ?? ??? ???? ??? ???? ????? – ???? ????? ??????? ?-factitious fever/ FUO ???? ???? – ???? ????????? ???? ???????? ?????? ?????, ?? ??? 5% ?? ??????? ??? ?????? ????? ????.

12. ????? ??????: ?? ,???? ??????? ??????????, ???, ???, ??? ???? ???? ??????, ??????????, ?????? HACEK ???' . ?? ???? ? 3-6 ?????? ?? ??? ????? ????? ??????? ????? ?-HACEK ?????. ?? ????? ?????? ?????? ????? ?? FUO, ??? ??? ????? ?????? ?????? ?????? ???????????? ?? ?????? ????? ???????. ???????? ??????? (????: ??????? ???? EBV CMV HIV ??????? ,??????, Q fever, ???????, ??????) ???????? ??????? (ANA , ANCA RF, , ????? ???, PEP ) ???? ???? ?????? ?? ??? ????: ???, ??, ???, ????? ??? (???? ADH, ???? ?? ??????????). ???????? ?????? ??? ??????? ???????? – ??????? ?????? ??? EBV, CMV, HIV, ????????? (carrier ?? ?????????), ??????, Q fever (???? ???? ?? ???? ????? culture negative endocarditis, ??? ?? ?????? ???????), ???????, ?????? – ????? ????? ?? ??? ???????? ????. ???????? ??????? – ANA , ANCA RF, , ????? ???, PEP. ??????????? - ?????? ?? ?????????.???? ???? ?????? ?? ??? ????: ???, ??, ???, ????? ??? (???? ADH, ???? ?? ??????????). ???????? ?????? ??? ??????? ???????? – ??????? ?????? ??? EBV, CMV, HIV, ????????? (carrier ?? ?????????), ??????, Q fever (???? ???? ?? ???? ????? culture negative endocarditis, ??? ?? ?????? ???????), ???????, ?????? – ????? ????? ?? ??? ???????? ????. ???????? ??????? – ANA , ANCA RF, , ????? ???, PEP. ??????????? - ?????? ?? ?????????.

13. ????? (????) ?????? ???????? ????? ?????????? ????? ?????? ????? ??? ?? ???? ????? ??????? ?? ?????-?????. ????? ??? ?? ????? ?? ???????????, ?????? ?? CMV. ???? ????? ??, ???, CSF, ??????? PCR ??????? ??????????, CMV, HCV. ?? ????? ?????? ?????? ??? ??? ??? ??????????? ??????? (?? ?? ?????? ??? ??????). ?? ????? ????? ?? (???? ???) ????? Plasmodium, Babesia, Borrelia, ??????? (Kala-Azar ). ????? ?????? ???' ?????????? ?????? ??? ?????? ??????? ?? ??????? ????????? (??? ?????? ?? ?????? ?????). ????? ??? ?? ????? ?? ???????????, ?????? ?? CMV. ???? ????? ??, ???, CSF, ??????? PCR ??????? ??????????, CMV, HCV. ??????? ???? ?? ????? ?????, ??????????? ???????. ?? ????? ????? ?? (???? ???) ????? Plasmodium, Babesia, Borrelia, ??????? (Kala-Azar).????? ?????? ???' ?????????? ?????? ??? ?????? ??????? ?? ??????? ????????? (??? ?????? ?? ?????? ?????). ????? ??? ?? ????? ?? ???????????, ?????? ?? CMV. ???? ????? ??, ???, CSF, ??????? PCR ??????? ??????????, CMV, HCV. ??????? ???? ?? ????? ?????, ??????????? ???????. ?? ????? ????? ?? (???? ???) ????? Plasmodium, Babesia, Borrelia, ??????? (Kala-Azar).

14. ????? (????) ????? ?? ? CRP : ???? ???? ????????, ?? ??????, ????? ????? ???? ????? ??? ?????? ????????? ? FUO???? PMR/GCA , ???? Still, ????????? ?????? ??????. PPD ?? ???? ??? ???? ?? FUO. ?? ??? ????? ???? ????? ???? ?????? ?? ???? ????????, ???????????, ????'???, ?? ?????, ?-AIDS. ?????? ??????: ????? ??, ????? ???? LDH ??????? ???, ??? ?????, ACE. ????? ????? ?? ?-CRP ???? ?? ????? ????? ?? ??. ????? ?-CRP ?????? ??????? ????? ??? (drug / factitious fever). ????? ???? ????? ?? ????? ?????? ??? ????????????, ???? still ??????. ?? ???? ???????, ??? ???? PDD ??? ???? ????, ?? ?? ????? ????? ??? ???? ?????? (?? ?? ????????????, ???'???, ??-????? ?-AIDS). ?????? ??????: ????? ??. ?????, ???? LDH – ???? ????????. ACE – ????? ????????????, ?? ?? ???????? (?).????? ????? ?? ?-CRP ???? ?? ????? ????? ?? ??. ????? ?-CRP ?????? ??????? ????? ??? (drug / factitious fever). ????? ???? ????? ?? ????? ?????? ??? ????????????, ???? still ??????. ?? ???? ???????, ??? ???? PDD ??? ???? ????, ?? ?? ????? ????? ??? ???? ?????? (?? ?? ????????????, ???'???, ??-????? ?-AIDS). ?????? ??????: ????? ??. ?????, ???? LDH – ???? ????????. ACE – ????? ????????????, ?? ?? ???????? (?).

15. ????? (Imaging ) ????? ??? ? CT ??? ?? ???? ??????? ???? ???? ?????? ?? FUO ?????? ??????? ???? ?????? ??? CT ??? ??? ????? ????? ?????? ?????? ?????????? ?????? ?????? ?? ????? ???? ??? ????????? ?? ???????. ?????? ???? ?? ???? ???? CT ?????? ??? ????? ??????. ????? ????????? ?? ??? ???? ????? ???? ??? ???? ??? ????? ? CT, ?? ?? ????? ????? ???? ???? ?? ?????? ?????? ?????? ?? ?????? ??????, ????? ????-?????? PET CT ????? ???? ????? ??? ?? ????? ?????? ???? ???? ???? ?????? FUO. ????? CT ??? – ????? ????? ??????, ???"? ?? ??????? ????? ??? ??????? ??? ???? ????????? ?? ???????. ????? ????????? ???? ?????, ???? CT ????? ???? ?? FUO ??? ???? ?-US. PET-CT ?????? ?? ?????? ??????? ??????? ?????? FUO. ????? ?????? ???? ???? ??? ?????? ?-PET. ????? ?? ????? ???? ???? ????? ???? ?? x-ray ???????, ????? ??????? ????? ?? ???????????, ???? ???????????? ?????? ???? ?? ????? ???? ?????. (?)????? CT ??? – ????? ????? ??????, ???"? ?? ??????? ????? ??? ??????? ??? ???? ????????? ?? ???????. ????? ????????? ???? ?????, ???? CT ????? ???? ?? FUO ??? ???? ?-US. PET-CT ?????? ?? ?????? ??????? ??????? ?????? FUO. ????? ?????? ???? ???? ??? ?????? ?-PET. ????? ?? ????? ???? ???? ????? ???? ?? x-ray ???????, ????? ??????? ????? ?? ???????????, ???? ???????????? ?????? ???? ?? ????? ???? ?????. (?)

16. ????? (Imaging )-???? ?? ?? ????? ???? ???? ?? ?????? ?????? ?"? CT ??? ??? ????? ?????? ????, ???? ???????. ??????????? ?? ??????? ???-???? ?????? ?????? ?????? ?????? ????????. ????? ???????????? ??????? ? CT ??????? ??? ????. MRI ??? ??? ??? ???? ???? ???????? ??????, ???????? ????-????????. ?????, ?? ?? ????? ?? CT ?????? ?????? ???-??????, ???????? ?? ???????. MRI – ???? ????. ????? ????? ???????? ?????? ?????-?????????.MRI – ???? ????. ????? ????? ???????? ?????? ?????-?????????.

17. ????? ?????? ????? ??????-???? ?????? ???????? ???? ????? ???????????? ?? ????? ????? ?? ?????????, ???? ???? ?????????? ???????, ???? PAN . TTE ????? ??????-TEE ?? ???? ??? ???? FUO, ?????? ???????????, ??????????, ????????. ????? ?????????? ??????? ? gallium-67 ?? indium-111 ??? ???? ????? ?????? ????? ?? ??????? ????? FUO. ?????? ??????? ?????? ?? ????????????, ???? Castelman , ???????????, ?- GCA.????? ????? ???? ????? ?? ????? ????? ? - PCP. ????? ????? ?????? ???? ?????? ????? ??????? ????? (?????? ?? ???????????? ???????), ?????? ????? (???? ??? ???). ????? ???????? ????? ??"? ????? ??? ???? ????? ????. ?????, PET CT ????? ?? ????? ?????? ?????? FUO. ?????????? – ??????????. ???- ?? ???? ?? FUO – TTE ????? ?-TEE ????. ????, ??????????? – ???????? ???????? ?????.?????????? – ??????????. ???- ?? ???? ?? FUO – TTE ????? ?-TEE ????. ????, ??????????? – ???????? ???????? ?????.

18. ????????? ???????? ???????? ?? ?????? ??????? ?? FUO ????? ?????? ?"? ???????? ?/?? ?????????. ???? ??????? ?? ??????? ??? ???? ????: ?????? ??? ???? ? –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– ????? ???????, ????. ????? ?????????. ??????? ???? ?-RES ???? ????? ?????? ?????? ?? ???. ?? ????? ??? ????????? – ????? ???? ?????? ??????, ?? ?? PET. ??? ????? ????-???????? ???????????, ?????? ???????.???????? ????? ??? ???? ????, ????? ??????? ????, - ?????? ????????? ???????? (???? ????????) ?? ?? ??????? (???????????). ???????? ?? ?? ??? – ????? ???????, ????. ????? ?????????. ??????? ???? ?-RES ???? ????? ?????? ?????? ?? ???. ?? ????? ??? ????????? – ????? ???? ?????? ??????, ?? ?? PET. ??? ????? ????-???????? ???????????, ?????? ???????.

19. ????? ????? ?? FUO ?? ???? ?? FUO ????? ????. ???? ??????? ???????? ??? ?? ??? ???? ????? ???????? ????. ??"? ??? ??????? ???? ????, ???? ????????? ???????? ??? ???? ????, ?????? ???? CT ??? ????????. ???? ?????? ??? ?????? ?????? ??? ???? ?? ????? ?????? ?????? ????? ?? ?????? ?????? ??????? (??????? ?? CT, ????????, ??????? ???'-??? ?????? ?? ???????). ?? ?????? ??? ????? ??????. ??' ??????? ??? ?? ???? ???? ???????? ????. ??????? ???? ????? ?????. ?? ???? ???? ?????? ???????, ???? ????? ?? ????? ??????. ???? ????????' ?? ?? ??????????? ?? ???? ?-CT ?????? ???? ???? ????? ???? evolved ?????? ???????. ???? ????? ?????? ???????? ?? non-specific inflamation ????? ????? ????????? ????. ??' ??????? ??? ?? ???? ???? ???????? ????. ??????? ???? ????? ?????. ?? ???? ???? ?????? ???????, ???? ????? ?? ????? ??????. ???? ????????' ?? ?? ??????????? ?? ???? ?-CT ?????? ???? ???? ????? ???? evolved ?????? ???????. ???? ????? ?????? ???????? ?? non-specific inflamation ????? ????? ????????? ????.

20. ????? ?? ????? ?????? ?????? ??? ????, ??? ?????? ??????? ?????? ?????????. ?? ????? ?????? ?????? ?"???????????" ??? ?????????? ??? "???" ???? ???? ?????? ??????. ??? ???? FUO ?? ???? ?????? ????. ?? PPD ??? ?????? ?? ?? ???? ????? ???????????? (??????? ??? ?? ?? ???) ??????? ?????? (???? ???? ????????????) ????? ????? ?????? ????? ? 2-3 ??????? ? 6 ?????? . ?? ???? ?????-???? ????? ????. ????? ?????? ?????? ?? ?????, ????? ????? ????? ?????? ??????, ???? ????? NSAID ?? CS ?????? ???? ?????? ?????? ?? ???? Still , ???? ?????, PMR/GCA , ?- Granulomatous hepatitis. ????????? ?? FUO> 6m ??? ????, ??????? ???, ????? ?????, ????? ?? ?? ????? NSAID ?/?? CS. ???? ?????? ?????? ??? ????? ??? ????? ?-drug fever. ???? ??? ??? ????? (drenching fever) – ????? ????? ?????? ???, ?? ????? ??? ?? ??? ????? – TEE ???? ???? ????????????, ?? ??? ????? ?-90%, ?? ?? ???? ?-TTE. ???? ???? ???? ????. ????? ?????? ?????? ???? ???? ??????????? ?? ?? ?????? ??? ?????????, ?? ??? ?? ?????? ??????. ???? ?????? ????, ???? ?????????, ?????? ????? ????? ????, ????? ????? ?? ?? ?????? ?????? ??????????- ?? ???? ????? ????? ?? ??????. ?-polymyalgia rheumatic ?????? ?? ??? ?????? – ????? ?? ???? ?????? ????, ?? ???? ????? ?????? ??? ???????? ????????. ???? ????? ??? ????? ???????? ?????, ?? ???? ???? ????? ?? ??? ??????-?????????. ???? ??? ????????? ???? ????? ?????? ??????? (???? still, ). ?-NIH ??? ????? ????? ??? ??? ?? polymyalgia???? ?????? ?????? ??? ????? ??? ????? ?-drug fever. ???? ??? ??? ????? (drenching fever) – ????? ????? ?????? ???, ?? ????? ??? ?? ??? ????? – TEE ???? ???? ????????????, ?? ??? ????? ?-90%, ?? ?? ???? ?-TTE. ???? ???? ???? ????. ????? ?????? ?????? ???? ???? ??????????? ?? ?? ?????? ??? ?????????, ?? ??? ?? ?????? ??????. ???? ?????? ????, ???? ?????????, ?????? ????? ????? ????, ????? ????? ?? ?? ?????? ?????? ??????????- ?? ???? ????? ????? ?? ??????. ?-polymyalgia rheumatic ?????? ?? ??? ?????? – ????? ?? ???? ?????? ????, ?? ???? ????? ?????? ??? ???????? ????????. ???? ????? ??? ????? ???????? ?????, ?? ???? ???? ????? ?? ??? ??????-?????????. ???? ??? ????????? ???? ????? ?????? ??????? (???? still, ). ?-NIH ??? ????? ????? ??? ??? ?? polymyalgia

21. OUTCOME ?? ?????: ????????? ????? ???? ??? ?????? ??????? ?????? ????? ????? ??????? ??????? ??????. ????????? ?????? ????? ?????? FUO ??? ????? ???????. ????? ?????? ??? ?????? ?????? ?? ??????? ???-?????? (??????? ?????? ?????), ???? ????????, ????? ??????? ????? ??????? ?????? ??????. ?????, ????????? ?? ???? FUO ??? ?????? ?? ???? ???? ??????- ????. ????? ???? ??? ?????, ??? ?????, ???? ?????? ???? ?????? ????. ???? ??????? ?? PMR ????? ???? ?? ?? ?????? ??? ????? ???? ? CS. ????????? ????? ???? ??? ?????? ??????? ?????? ????? ????? ??????? ??????? ??????. ????????? ?????? ????? ?????? FUO ??? ????? ???????. ?? ???? ???? ???????? ???, ?? ???? ??? ??????, ?-outcome ?????? ???? ?????? ????. ????? ??? ?? ?????? ????? ???????: ???? ????????, ???????????. ????? ?????? ??? ?????? ?????? ??: ??????? ???-?????? (????? ?????? ?????). ???? ????????. ????? ??????? ?????. Recurrent PE – ????? ????? ??? underdiagnosed. ????? ??????????? ?????? ??? staging ?????? ????? ????, ??? ?? ????, ??-CT ???? ?????? ??????? ???????. ????? ???? ??? ?-CT ???????', ?-recurrent shower ???? ?????? ?? ?-FUO ??? ?? ????? ?????? ?? ??? ???? ???'. ??????????? - ???? ?? ion ??????? ?????? ?????? ?????? ?????????? ?????? ?-temporal arteritis, ????? ?? ??? ????, ???????????? ??? ????? ????? ?? temporal arteritis (??? ???? ???? ??????? ???????). ?? ????? ????? ??????? ???? ????? CT ???, (?)????????? ????? ???? ??? ?????? ??????? ?????? ????? ????? ??????? ??????? ??????. ????????? ?????? ????? ?????? FUO ??? ????? ???????. ?? ???? ???? ???????? ???, ?? ???? ??? ??????, ?-outcome ?????? ???? ?????? ????. ????? ??? ?? ?????? ????? ???????: ???? ????????, ???????????. ????? ?????? ??? ?????? ?????? ??: ??????? ???-?????? (????? ?????? ?????). ???? ????????. ????? ??????? ?????. Recurrent PE – ????? ????? ??? underdiagnosed. ????? ??????????? ?????? ??? staging ?????? ????? ????, ??? ?? ????, ??-CT ???? ?????? ??????? ???????. ????? ???? ??? ?-CT ???????', ?-recurrent shower ???? ?????? ?? ?-FUO ??? ?? ????? ?????? ?? ??? ???? ???'. ??????????? - ???? ?? ion ??????? ?????? ?????? ?????? ?????????? ?????? ?-temporal arteritis, ????? ?? ??? ????, ???????????? ??? ????? ????? ?? temporal arteritis (??? ???? ???? ??????? ???????). ?? ????? ????? ??????? ???? ????? CT ???, (?)

22. ???? ?? NIH ?? 350 ????? ??? 6 ?????? – ????? ????? ????. 25% ?????? ??? ?????, ????? ?????? ???????: granulomatous hep (?????: ?????????), factitious ever (??? ???????, ??? ???? ???? ???? ?????, ??? ????? ????????? ???? ???????????? ?? ????? ??? ????), 10% unknown, ????? ?????, ???? still ?-JRA.???? ?? NIH ?? 350 ????? ??? 6 ?????? – ????? ????? ????. 25% ?????? ??? ?????, ????? ?????? ???????: granulomatous hep (?????: ?????????), factitious ever (??? ???????, ??? ???? ???? ???? ?????, ??? ????? ????????? ???? ???????????? ?? ????? ??? ????), 10% unknown, ????? ?????, ???? still ?-JRA.

23. ????? ??????-??????? ???????? ?????? ??? ????? ????? ????? FUO??????: ????, ??????? ???-????? ?? ?????? ?????? ????????????? ??????, ??????? CMV ?????? ??? ?????? ??? ?????? ???????, ???????????????, ???????????? Renal malakoplakia ??????? ?????? ??"? ?"? ?????????? ?????????????, ??????? ?????? ????????? ??????????? ??????? ??????? ????????, ???? ????????????? ????? ??????? ?????? ????? ?-FUO: ????, ????? ??? ?????? ?? miliary (?? ?????? ???). ?????????????, CMV – 5% ?????? ?????? ?????. ?????? Renal malakoplakia – ???? ????? ???????????. ?????????????, ??????? ?????? ????????? ??????? ?????????.??????? ?????? ????? ?-FUO: ????, ????? ??? ?????? ?? miliary (?? ?????? ???). ?????????????, CMV – 5% ?????? ?????? ?????. ?????? Renal malakoplakia – ???? ????? ???????????. ?????????????, ??????? ?????? ????????? ??????? ?????????.

24. ????? ??????-??????? (????) ????:???? ????? ?????? ??"? ? - FUO ??? ???? ???????? ????? ???? ??????? ?????? ?????? ??? ?? ???? ???-????? ??? ???? ????. ???? ?????? ??? ???? ????? ?????? ?????? ?????? ????? ? – FUO. ??????? ??? ?????? ???? ????? ??????? ????????? ?? ??????, ????? ??? ????? ?????? ?? ???? ?????? ????? ?? ?????. PPD ??? ????? ?????? ?????? ?????? ???? ?????? ???????? ????? ????? ? -50% 25- ???????. ??????? ??? (?? ????) ?????? ? 80-90% ??????? ?????????? ???? ????? ?????? ?/?? ??????? ? ???? ????? ??????? ?? ??? ?????? ? – 50%, ?? ???? ?????? ? 80% ??????? ?????, ????????? ????????????. ???? ?????? ????????, ??? ???? ????? ?????? ?????? ?????? ????? ?-FUO. ??????? ???? ????????, PPD ????? ?????? ??????. ???? ????? ???????? ??????? ?? ????? PCR ???????.???? ?????? ????????, ??? ???? ????? ?????? ?????? ?????? ????? ?-FUO. ??????? ???? ????????, PPD ????? ?????? ??????. ???? ????? ???????? ??????? ?? ????? PCR ???????.

25. ???????-???? ????? BAL ???? ????? ?????? ??????, ?? ???? ????? ??????? ????? ?????. ???? ????? ??????? ? PCR ?????? ????, ?? ?? ????? ?? ?????? ??????. ??? ????: ?? ????? ??????? ????????? ?????? ??? ?? ??? ????? ?????? ??? ????? ????? ?????? ??????.

26. ???????-???? ?????? ?? 2% ???? ???? FUO. ?????? ?? ?????? ???? ?? ???? ???? ??? ????? ?????? ?? ??? ????, ?????? ?????? ?????? ????, ????: ?????, ???? ???, ????? ?????. ?? ???? ?????? ???? ????? ??????? ??????? ???, ????, ????. ?????? ?????? ????? ??"? ?????? ?????? ?????? ??? ????? ????. ?? ????? ????? ????? ??????? ???? ????? , ????: ???? ????? ??????? ?????? ?? ??????????????? ??????????? ??????? ?????. ???? ???? ??? ??????? ????. ?????????? ? ?????? ????? . ????? lavage ?? ???? ???? ??????, ?? ?? ????? ????? ?? cavity, ??? ???? ???????. ???? ?????? ???? ????? ?????? ?????? ??? ?????, ???? ???, ????, ???? ????, ??????. ?-CT ??? ???? ??????? ?? ??? ???? ?? 38 ???? ??? ?????? ???? ??? ???? ?? ?????. ??????? ?????? ??????? ?????????. ???? ????? ?? ????, ??????????? ?? ????? ?????????? ????????.????? lavage ?? ???? ???? ??????, ?? ?? ????? ????? ?? cavity, ??? ???? ???????. ???? ?????? ???? ????? ?????? ?????? ??? ?????, ???? ???, ????, ???? ????, ??????. ?-CT ??? ???? ??????? ?? ??? ???? ?? 38 ???? ??? ?????? ???? ??? ???? ?? ?????. ??????? ?????? ??????? ?????????. ???? ????? ?? ????, ??????????? ?? ????? ?????????? ????????.

27. ???????-???? ?????, ?? ????? ??????? ?????? ?? FUO, ??? ??????? ??????. ?? 4/167 ???? FUO ?? deKlein (2%). ?? ?????? ?????? ??????, ??? ????? ?????? ??????? ??? 5 ???? ??????, ??? ???? ?????? ?? ???????? ?? ???? ?????. ???????: ??????? ?? ???? ?? ??? ??? ?????? ???????? ?? ???? ?? ??? ???? ?????? ?????. ???? Coxiella burnetti ????? ????? ??? ???????. TEE ????? ?????? ???? ????? ? 90% ???????. ???? ????? ?? culture negative endocaridtis. ????? ??????? ???????.???? ????? ?? culture negative endocaridtis. ????? ??????? ???????.

28. ???????-???? ??? ????????? ?? ????????????? ?- CMV ??????? ?? ??? ??? 3 ??????. ?????? CMV ? FUO ??? 3%. ?? ?????? ?????? ?? ???? ????, ???? ????, ???????? ?? ????? ????. ???? EBV ?- HIV ?????? ?? ?? ?????? ?????????????? ??????, ?? FUO ??? ?????? ?????? ?????? ????? ? CMV. ??? ???? ?? CMV ?????? (?? ?? ?? ????? ?????? ??????) ???????????? ????? ???????????. ?????? ??? ????????, ?? ???? ????? ?? ?????? ????. ?????? CMV ????? ????? (3%), ???? ?? ????? ????????, ???? ????????? ?? ???????.?????? CMV ????? ????? (3%), ???? ?? ????? ????????, ???? ????????? ?? ???????.

29. ??????? ?????? ??????? ??????? ???? ???? ??? ???? ???????, ?? ??? ????? ??????, ????? ???? ?????? ????? ???? ??? ???? ???? ??????? ?? FUO. ?????? ???????? ??? ????? ???????? ???? ??????: ???? ????'??? ??????? ????? ????'??? ??????? ?????????? ?????? ???????? ?? ???? ??? ????????? ???? ????'???. ??????? ????? ????'???. ???????. ?????????? – renal cell CA, ????? ????. ??????. ???????? ?? ???? ??? – ????? ?? ???? ?? ????? ???? ???. ????????? ???? ????'???. ??????? ????? ????'???. ???????. ?????????? – renal cell CA, ????? ????. ??????. ???????? ?? ???? ??? – ????? ?? ???? ?? ????? ???? ???.

30. ??????? ??? ?????? ??"? ?? ????????? ???????? ??? ?????? ?????????? ????, ???? Intra vascular lymphoma . ????? B (???, ?????, ????? ????) ?????? ???? ?? ?????? ??????, ?? ?????? ??? ????? ?????? ???????. ????? ???????? : ????? ???? ????? ?/?? ???? ????? ?? ?????????? LDH ???? ??? ??"? ???? ????? ?????? ????? ???????? ?"? ????? ????? ?????? ????, CT ???, ??? ???? ?????? ?? ???. ??????? ??? ????? (??? ?????) ??? ????????? ????????. ??????? ?????: ????? ADH ???? ????????????? ???? ??????? ????. ?????? ??? ?? ??? ?????????, CT, ???????.??????? ?????: ????? ADH ???? ????????????? ???? ??????? ????. ?????? ??? ?? ??? ?????????, CT, ???????.

31. ???????-???? ?-15% ??????? ?????????? ??????? ????, ?????? ??????? ?????? ????. ????? ??????: ??????? ??????????? ??????? ????????????? (??? ???????????? ?????). ????? ??????? ??? ??????? ?? ????? ??????, ??? ????? ???? ????? ??????. RCC ?????????? ??? ????? ????? ????? ???? ???????? (???? ?? ??????????). ????? ?? ??????? ?? ????????????. ??????? – ???? ??? ??????? ?????????????, ?????? ????? ?????0-???????????.RCC ?????????? ??? ????? ????? ????? ???? ???????? (???? ?? ??????????). ????? ?? ??????? ?? ????????????. ??????? – ???? ??? ??????? ?????????????, ?????? ????? ?????0-???????????.

32. "????? ??????" ???? ???? ???????? ?????? ?????? ???? ?? FUO. ?????? ??? ?????? ????? ???? ?????? ?? ????? ??????? ??? ??? ?????. ??????? ????????: ??? ????, ????? ?????, ???????? ?? ???????? ???? ????, ????? ?? ?? ???? ????. ??????? ????? : ???, ???????? (????????), ???????, ???? ???? ????????????, ?????????? ????????? ??????????? ???? ??? ???? ???????? ???? ????? ????. ????? ????? ????? ?????, ????? ???? ????? ?? ????, ?? ??? ???? (????????: ????? ??????????? ????????????). ????? ????? ???? ??????? ??????? ?? ?????? ?????. ??????: ?????, ????? ?? ?????, ??????????? ???????????? ???? ??????? ??? ????? ?????? ?????? ???. ??? ?????: ???????. ??????: NSAID ?? CS. ???? Still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till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

33. "????? ??????" ?????? ????? ???? ?? ????: ????? ???? ? –55, ?? ??????? ????? ?? 15% ???? ?????? ?? FUO ?????? ?????? ???? ???, ??????, ????????, ????? ????, ?????, ?????, ?????, ????? ?? ?????, ????? ?????? ?????? ???? ???? ??? ?? ?????? ????????? ?????? ????? ????? ????? ? ?-20% ???? ??????. ????? ????????? ???? ?????? ?? ?????? ??????. PMR ????? ?? ????? ? ? –20% ???????, ?????? ??????? ?????? ?????? ??????, ???????, ?? ?????, ?????? ???????. ??????? ??????? ???? ??????. ?????? ??????? ???????? ?????? ???? ?? CS (?? ?? ? NSAID) ???????. ????? ???? ?? FUO ?????? ?? ????? ??? ?????? ???? ??????? ???? ????????, ?? ?? ??? ?????? ??????, ????? ??????? –?????? ????. Giant cell ???? ??????? ?-FUO ????. ???? ???? ?? ??? FUO ?????? ?? ????? ?? ????? ????? ?? ??? ?????? ????.Giant cell ???? ??????? ?-FUO ????. ???? ???? ?? ??? FUO ?????? ?? ????? ?? ????? ????? ?? ??? ?????? ????.

34. "????? ??????" ????? ????? ???? ?????? ????? ????? ?? ????? ?? ???????: ???, ???????, ???????? ?????? ????. ??????? ??? 1-2% ???? ???? FUO ( deKlein 1997-Knockharet 1992 ). ?? ???? ????? ??????, ??? ????? ???????? ??????, ??"? ?????? (????? ??"? ???) ??????? ?????? (???? ???, ?????, ?????????). ?????? ??????? ??????: Mononeuritis multiplex ?????? ?????? Livedo reticularis ?????, ????? ?? ?????, ???????????? ???????? ?? ?????. HbSAg ????? ? 15% ???????. ANCA (??"? anti-MPO) ?????? ????? Microscopic polyarteritis/polyangiitis ?????: CS ?????? Cyclophosphamide PAN ????? ????? ???? ?????? ????? ????? ?? ????? ?? ???????: ???, ???????, ???????? ?????? ????. ??????? ??? 1-2% ???? ???? FUO. ?? ???? ????? ??????, ??? ????? ???????? ??????, ??"? ?????? (????? ??"? ???) ??????? ?????? (???? ???, ?????, ?????????). PAN ????? ????? ???? ?????? ????? ????? ?? ????? ?? ???????: ???, ???????, ???????? ?????? ????. ??????? ??? 1-2% ???? ???? FUO. ?? ???? ????? ??????, ??? ????? ???????? ??????, ??"? ?????? (????? ??"? ???) ??????? ?????? (???? ???, ?????, ?????????).

35. ????? ????? ??????? ???? ????. ????? ????? ???? ?????? ???, ???? ?????, ?????? ??????. ?????? ?? 3/167 (2%) ???deKlein ?-4/199 (2%) ??? Knockharet. ??????? ???????? ?? Uveoparotid fever (Heertford Syndrome: Uveitis, parotitis, facial n. palsy (??? Lefgren’s Syndrome (???????? ???????, ???????? ??????? ???????). ??? ????? ?????? ??????. ACE ???? ? 66%, ?? ?? ?? ?????? ?????? ???????. ?????? ???? ?? ??????, ????? ? CD4+T cells ??? ???? ???????? ???????? ?? BAL. ????? ???? (?? CT) ????? ??"? ?? ????????? ??????? ???-????? ????????? ?/?? ??????? ????????. ????? ????? ????? ?????? ?? ???? ?????. ??????? ???? ????????? ??? ??????. ?????? ??? CS ?/?? MTX. ??????????? ???? ??????, ????? ??????? ???? ????, ????? ??????? ??????? ?????? ?? ??????? ??????? ?? ???, ??? ????? ??????. ACE ???? ?-2/3 ???????, ?? ?? ?????? (?? ????????). ?????? ?? ?????? PCR ????? ?-TB ,???? ??????????? ???? ??????, ????? ??????? ???? ????, ????? ??????? ??????? ?????? ?? ??????? ??????? ?? ???, ??? ????? ??????. ACE ???? ?-2/3 ???????, ?? ?? ?????? (?? ????????). ?????? ?? ?????? PCR ????? ?-TB ,????

36. ????? -???? ????? ?????: ??? ???????? ??????? ??????? (?? ?? ????) ??????? ???? ?? ??? ???????? ????? ???? ???????? ????? ????? ?? ??????? ??????? ?? ????? ????? ?? URI ????? ???? ? NSAID ?? CS ??????, ?? ??? ?????, ????? ?????? ???? ????? ?????? ????. ??"? ?? ??????????????? ?? ??? ?????? ????? ?????? ? CT. ??? ???? ??????: ?????? ????? ????? ????? ??????? "????" ???????. ??????????? ???-????? ??? ??????? ???, ?????? ?"? ????????, ????? ????, ????? ??, ????, ???? ??????????, Derecant. ??????? ?????? ???????? ????? ??????? – ???? ????? ?-CT ?? MRI. Recurrent PE (?)??????????? ???-????? ??? ??????? ???, ?????? ?"? ????????, ????? ????, ????? ??, ????, ???? ??????????, Derecant. ??????? ?????? ???????? ????? ??????? – ???? ????? ?-CT ?? MRI. Recurrent PE (?)

37. ?????-???? ?????? ? 3% -–1% ????? FUO. ?? ????? ???????? ????? ????? ????? ????? ?????. ?????: ??? ???? ??? ???????? ???? ??? ?????? ???? ???? ????? ??????? ?????? ??? ?? ???? ??? ???????. ?? ????? ????? ????? ??? ??????? ?"? ?????? ????? ???. ?????? ????? ?????? ????? ?"? ????? ????? ??? ??????? ??????? ???????? ???????????????? ??? ????. ??? ?? ??????? ???????????????? ?? ??????? ?????? ?? ????? ???? (???????? ??????? ?? ??????) ??? ????. ???? ??? ?????? ????, ???"? ?? ??? ????? ?? ???-?????. Factitious fever ??? ??? ????????, ????? ???? ???, ????? ????? ?? ??? (??"? ??? ???? ???? ????? ?????). ??????? ?????? ?? ?????? ???? ???? ?????? ?? ??? ????? (?????).Factitious fever ??? ??? ????????, ????? ???? ???, ????? ????? ?? ??? (??"? ??? ???? ???? ????? ?????). ??????? ?????? ?? ?????? ???? ???? ?????? ?? ??? ????? (?????).

38. ?????-???? ??? ????? ???????? ???? ??????. ?????? ??????, ?? ??????? ?????? ??????, ?????? ?? ???????????? ?/?? ?????-????? ?? ? –20% ??????? ????, ???? ????? 1-3 ?????? ???? ????? ??????. ?????? ??????? ?????? ???? ???? ??? ???? ??????, ???"? ??? 2-3 ????. ?? ????? ??? ?????! ?? ??????? ?????? ????? ??????? ????? ?????? ???? ??? ?? ???? ???? ??????? ?- NSAID. ??????????? ???? ????????, ????????, ??????? ????? ?????????? ?? ??????? ?????. ??? ?????? ??? ???? ?????? – ??????? ????? ?? ?????, ???????????? ??????. ?? ????? ??????? ?????? ????. ??????: ????? ??????. ????? ?????? ?? ?? ??????? ????? ?? ???.??? ?????? ??? ???? ?????? – ??????? ????? ?? ?????, ???????????? ??????. ?? ????? ??????? ?????? ????. ??????: ????? ??????. ????? ?????? ?? ?? ??????? ????? ?? ???.

39. Nosocomial FUO ?? ???? ?? ?????? ????? ????? ?????? ?? ???????? ?????-??????, ?????, ?? ??? ?? ?????. ????? ?????? ???? ????? ?? ????? ????? ??????????? (?????) ??? ?????. ?? ???? ???? line sepsis, ??????? ?????, ????????? ???????. ?? ???? ????? ?? ????? ????, ????: ???????-????? ?????, ????? ????????, ????? ?? ????. ????? ? C. difficile ???? ?????????????? ?????? ?????? ?? ??????. ?? ???? ??? ?????.?? ???? ??? ?????.

40. Nosocomial FUO -???? ???? ??????? ????? ???? ???? ?????. ????? ?????? ??: Acalculous cholecystitis DVT ?- PE ????? ??????: ??? ??????? ????? ???? ????? ?? ????? ???????/???? Gout/Pseudogout ??????????, ???????????, ?? ????? ???????

41. Nosocomial FUO -???? ????? ????? ???????, ?- 20% ???? ?????? ?? ???????. ????? ???????? ????? ????? ?????. ?? ?????? ?????? ???????, ??????, ????? ????? ???? ????????? ?? 72 ????, ??????? ????? ?????? ?????????, ????? ?????? ????"?. ????? ????? ????? Vancomycin ?????? ????? ??? ???? ???? ???????, ???? Tazocin”" , Imipinem , ?? Meropenem.

42. Neutropenic FUO ????? ???? ????? ?? ????? ????? ?????????? –?????. ????? ?????????? ???? ?: ??????? ??????? ??????? ?????? ???????, ???? ????????????? ????? ??????? ?????????. ?????? ?????????? ?? ?????? ??????. ?? ????? ?????? ?? ??????? ????? ??-CMV. ?? ?? ??? ???? ???, ?????? ??? ?-60% ????? ??-20% ???????! ?? ??? ?????? ????? ?????? ??? ????, ???? ???? ?????? ??, ??? ???'. ????????? ???, ????? ???? ????????, ????? ?????, ?"? ????-??????? ????? ??????? (???:?????????+ ???????? ). ?? ???? ?-FUO, ??? ?? ?????.?? ???? ?-FUO, ??? ?? ?????.

43. HIV-Associated FUO HIV ??????? ??? ???? ????, ?? > 80% ?? ???????. ????? ???? ????? ??? ???? ?? ????? ??????? ???????? ???????? ??? ???? ??? CD4+ T cells. ????? ???? ??????? ????? HIV ??????: M. avium/M. Intracellulare, M. Tuberculosis CMV Toxoplasma, P. Carinii Salmonella Cryptococcosis, Histoplasmosis Non-Hodgkin Lymphoma Drug fever –????!

44. HIV-Associated FUO- ???? ?????, ??? ?????? ??? ??????? ?? ?????? ??????? ???? ????? HIV. ?????? ???? ??? ???????, ???????? ????, ?? ??? ???? ????? (?????? ??????????, ??? ????). CT ??? ?????? ???? ????? ?? ???????. ?????? ???????? ??????????? ??????. ????? ????? ?????? ????? ?? PCP.

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