Feld Thrombophlebitis
Feld Thrombophlebitis


Feld Thrombophlebitis

Feld Thrombophlebitis

A more recent article on this topic is available. Feld Thrombophlebitis four categories of potential etiology of FUO are classic, nosocomial, immune Feld Thrombophlebitis, and human immunodeficiency virus—related. The four subgroups of the differential diagnosis of FUO are infections, malignancies, autoimmune conditions, and miscellaneous. A thorough history, physical examination, and standard laboratory testing remain the basis of the initial evaluation of the patient wie die Leisten Krampfadern in der Behandlung von Männern FUO.

Newer diagnostic modalities, including updated serology, viral cultures, computed tomography, Feld Thrombophlebitis, and magnetic resonance imaging, have important roles in the assessment of these patients, Feld Thrombophlebitis.

Adult patients frequently present to the physician's office with a fever temperature Feld Thrombophlebitis than Occasionally, simple testing such as a complete blood count or urine culture is required to make a definitive diagnosis. Although some persistent fevers are manifestations of serious illnesses, most can be readily diagnosed and treated, Feld Thrombophlebitis. The definition of fever of unknown origin FUOas based on a case series of patients, 3 calls for a temperature higher than This strict definition Feld Thrombophlebitis common and self-limiting medical conditions from being included as FUO.

Some experts have argued for a more comprehensive definition of FUO that takes into account medical advances and changes in disease states, such as the emergence Feld Thrombophlebitis human immunodeficiency virus HIV infection and an increasing number of patients with neutropenia.

Others contend that altering Varizen labia majora während der Schwangerschaft Kompressionskleidung definition would not benefit the evaluation and care of patients with FUO.

The four categories of potential etiology of FUO are centered on patient subtype—classic, nosocomial, immune deficient, and HIV-associated. Each group has a unique differential diagnosis based on characteristics and vulnerabilities and, therefore, Feld Thrombophlebitis, a different process of evaluation Table 1. Clostridium difficile enterocolitis, drug-induced, pulmonary embolism, septic thrombophlebitis, Feld Thrombophlebitis, sinusitis.

Cytomegalovirus, Mycobacterium avium-intracellulare complex, Pneumocystis carinii pneumonia, Feld Thrombophlebitis, drug-induced, Kaposi's sarcoma, lymphoma. Fever of unknown origin—reexamined and redefined. Curr Clin Top Infect Dis ; The classic category includes patients who meet the original criteria of FUO, Feld Thrombophlebitis a new emphasis Feld Thrombophlebitis the ambulatory evaluation of these previously healthy patients.

Nosocomial FUO is Feld Thrombophlebitis as fever occurring on several occasions in a patient who has been hospitalized for at least 24 hours and has not manifested an obvious source of infection that could have been present before admission. A minimum of three days of evaluation without establishing the cause of fever is required to make this diagnosis.

In patients with nasogastric or nasotracheal tubes, sinusitis also may be a cause. Immune-deficient FUO, also known as neutropenic FUO, is defined as recurrent fever in a Feld Thrombophlebitis whose neutrophil count is per mm 3 or less and who has been assessed for three days without establishing an etiology for the fever.

These patients are usually treated with broad-spectrum antibiotics to cover the most likely pathogens. Occult infections caused by fungi, such as hepatosplenic candidiasis and aspergillosis, must be considered.

HIV-associated FUO is defined as recurrent fevers over a four-week period in an outpatient or for three days in a hospitalized patient with HIV infection. The differential diagnosis of FUO in patients who are HIV positive includes infectious etiologies such as Mycobacterium avium-intracellulare complex, Pneumocystis carinii pneumonia, and cytomegalovirus. For example, a patient with HIV who lives in the southwest United States is more susceptible to coccidioidomycosis, Feld Thrombophlebitis.

In patients with HIV infection, non-infectious causes of FUO are Feld Thrombophlebitis common and include lymphomas, Kaposi's sarcoma, and drug-induced fever. The differential diagnosis of FUO generally is broken into four major subgroups: Several factors may limit the applicability of research literature on FUO to everyday medical practice. These factors include the geographic location of cases, the type of institution reporting results e. Despite these limiting factors, infection remains the most common cause of FUO Feld Thrombophlebitis study reports.

Of the many infectious diseases that are associated with FUO, tuberculosis especially in extrapulmonary sites and abdominal or pelvic abscesses are the most common. Other common infections that should be considered as the source of FUO include subacute bacterial endocarditis, sinusitis, osteomyelitis, and dental abscess. Malignancy and factitious fever are more common diagnostic considerations in patients with prolonged FUO.

Because of a substantial increase in the elderly population, as well as advances in the diagnosis and treatment of diseases common in this population, Feld Thrombophlebitis, malignancy has become a common etiologic consideration in elderly patients. Malignancies that sometimes are difficult to diagnose, such as chronic leukemias, lymphomas, renal cell carcinomas, Feld Thrombophlebitis, and metastatic cancers, often are found in patients with FUO.

Rheumatoid arthritis and rheumatic fever Feld Thrombophlebitis inflammatory diseases that used to be commonly associated with FUO, but with advances in serologic testing, Feld Thrombophlebitis, these conditions usually are diagnosed more promptly. At this time, adult Still's disease and temporal arteritis have become the most common autoimmune sources of FUO because they remain difficult to diagnose even with the help of laboratory testing.

Multisystem inflammatory diseases such as temporal arteritis and polymyalgia rheumatica have emerged as the autoimmune conditions most frequently associated with FUO in patients older than 65 years. Many unrelated pathologic conditions can present as FUO, Interne Krampfadern drug-induced fever being the most common, Feld Thrombophlebitis. Complications from cirrhosis and hepatitis alcoholic, granulomatous, or lupoid are also potential Feld Thrombophlebitis of FUO, Feld Thrombophlebitis.

Even if an extensive investigation does not identify a cause for FUO, these patients generally have a favorable outcome. The initial approach to the patient presenting with fever should include a comprehensive history, physical examination, and appropriate laboratory testing.

As the underlying process develops, the history and physical assessment should be repeated. The first step should be to confirm a history of fever and document the fever pattern. Classic fever patterns such as intermittent, relapsing sustained, and temperature-pulse disparity may prove to be useful but rarely are diagnostic. In taking a history from a patient with FUO, particular attention should be given to recent travel, exposure to pets and other animals, the work environment, and recent contact with persons exhibiting similar symptoms, Feld Thrombophlebitis.

In patients returning from areas where tuberculosis and malaria are common, the index of suspicion for these Feld Thrombophlebitis should be elevated. In patients who have had contact with pets or other animals, diseases common to animal handlers must be suspected. The family history should be carefully scrutinized for hereditary causes of fever, such as familial Behandlung der unteren Extremität Thrombophlebitis traditionelle Methoden fever.

The Feld Thrombophlebitis history also must be examined for conditions such as lymphoma, rheumatic fever, Feld Thrombophlebitis, or a previous abdominal disorder e. Finally, drug-induced fever must be considered in patients who are taking medications. Diagnostic clues often are not readily apparent on physical examination; repeated examination may be essential, Feld Thrombophlebitis.

Careful attention to the skin, mucous membranes, and lymphatic system, as well as abdominal palpation for masses or organomegaly, is important. The physician's choice of imaging should be guided by findings from a thorough history and physical examination 21 e.

Also, Feld Thrombophlebitis, Duke's clinical criteria include two major and six minor criteria that help determine the likelihood of endocarditis. Algorithm for the diagnosis of fever of unknown origin, Feld Thrombophlebitis. The preliminary evaluation helps in the formulation of a differential diagnosis and guides further studies that are more invasive or Krampfadern unter dem Knie schmerzt. These preliminary investigations should include a complete blood count, liver function test, erythrocyte sedimentation rate, urinalysis, and basic cultures.

Simple clues found during initial testing often will guide the clinician toward one of the major subgroups of FUO, Feld Thrombophlebitis. The decision to obtain further diagnostic studies should be based on abnormalities found in the initial laboratory work-up and not represent a haphazard use of costly or invasive modalities.

Skin testing for tuberculosis with purified protein derivative PPD is an inexpensive screening tool that should be used in all patients with FUO who do not have a known positive PPD reaction. However, Feld Thrombophlebitis, a positive PPD reaction alone does not prove the presence of active tuberculosis.

A chest radiograph also should be obtained in all patients to screen for possible infection, collagen vascular disease, or malignancy. If this initial assessment does not disclose the source of fever, more specific investigatory techniques, such as serology, sonography, computed tomography CTmagnetic resonance imaging MRIand nuclear medicine scanning should be conducted, based on clinical suspicion.

Abdominal sonography, Feld Thrombophlebitis, pelvic sonography, or CT scanning should be performed early in the diagnostic process to rule out such common causes of FUO as intra-abdominal abscess or malignancy, depending on the primary evaluation, Feld Thrombophlebitis. MRI should be reserved for clarifying conditions found through the use of other techniques or when the diagnosis remains obscure. Tuberculosis, malignancy, Pneumocystis carinii pneumonia.

Endoscopic procedures may be helpful in the diagnosis of disorders such as inflammatory bowel disease and sarcoidosis. This modality appears to have a very high negative predictive value in ruling out inflammatory causes of fever.

However, because of its limited availability it is too early to determine if PET scans will prove to be a useful diagnostic tool in Feld Thrombophlebitis evaluation of these patients. More invasive Feld Thrombophlebitis, such as lumbar puncture or biopsy of bone marrow, Feld Thrombophlebitis, liver, or lymph nodes, should be performed only when clinical suspicion shows that these tests are indicated or when the source of the fever remains unidentified after extensive evaluation.

When the definitive diagnosis remains elusive and the complexity of the case increases, an infectious disease, rheumatology, or oncology consultation may be helpful. Already a member or subscriber? He is also associate professor of community and preventive medicine at Mount Sinai School of Medicine. Address correspondence to Alan R. The authors indicate that they do not have any conflicts of interests. National Ambulatory Medical Care Survey: J Allergy Clin Immunol. Fever of unexplained origin: Fever of unknown origin.

Infect Dis Clin North Am. Feld Thrombophlebitis Clin Top Infect Dis, Feld Thrombophlebitis. Konecny P, Davidson RN. Pyrexia of unknown origin in the s: Br J Hosp Med.

Sinusitis in Feld Thrombophlebitis intensive care unit patient. Otolaryngol Head Neck Surg. From the Infectious Diseases Society of America. Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever, Feld Thrombophlebitis. Human immunodeficiency virus—associated fever of unknown origin: Feld Thrombophlebitis of unknown origin FUO. A prospective multicenter study of patients with FUO, using fixed epidemiologic entry criteria.

Recurrent or episodic fever of unknown origin. Review of 45 cases and survey of the literature. Fever of unknown origin: Prolonged fever of unknown origin FUO:

Verlag und Vertrieb von Büchern und Druckschriften der experimentellen Onkologie und anderer medizinischer Fachbereiche.

Anhaltszahlen für die Mindestverweildauer. Darminfektion durch enteropathogene Escherichia coli. Darminfektion durch enterotoxinbildende Escherichia coli. Darminfektion durch enteroinvasive Escherichia coli. Darminfektion durch enterohämorrhagische Escherichia coli, Feld Thrombophlebitis. Sonstige Darminfektionen durch Escherichia coli. Bakterielle Darminfektionen, nicht näher bezeichnet.

Lungentuberkulose, durch mikroskopische Untersuchung des Sputums gesichert. Lungentuberkulose, nur durch Kultur gesichert. Lungentuberkulose, durch nicht näher bezeichnete Untersuchungsverfahren gesichert. Lungentuberkulose, bakteriologisch und histologisch nicht gesichert.

Lungentuberkulose, bakteriologische und histologische Untersuchung nicht durchgeführt. Lungentuberkulose ohne Angabe einer bakteriologischen und histologischen Sicherung. Sonstige atypische Schwere Beinschmerzen mit Krampfadern des Zentralnervensystems. Zoster mit Beteiligung anderer Abschnitte des Nervensystems. Sonstige näher bezeichnete akute Virushepatitis. Bösartige Neubildung an der Zungenunterfläche.

Bösartige Neubildung an den vorderen zwei Drittel der Zunge, Bereich nicht näher bezeichnet. Bösartige Neubildung der Zunge, Feld Thrombophlebitis, mehrere Teilbereiche überlappend. Bösartige Neubildung der Zunge, nicht näher bezeichnet. Bösartige Neubildung des vorderen Teiles des Mundbodens. Bösartige Neubildung des Mundbodens, mehrere Teilbereiche überlappend.

Bösartige Neubildung des Feld Thrombophlebitis, nicht näher bezeichnet. Bösartige Neubildung des Fossa tonsillaris Gaumenmandelnische. Bösartige Neubildung des Gaumenbogens vorderer hinterer. Bösartige Neubildung der Tonsille. Bösartige Neubildung der Tonsille, Feld Thrombophlebitis, nicht näher bezeichnet. Bösartige Neubildung des postcricoidea. Bösartige Neubildung der aryepiglottischen Falte, hypopharyngeale Seite.

Bösartige Neubildung der Hinterwand des Hypopharynx. Bösartige Neubildung des Hypopharynx, mehrere Teilbereiche überlappend. Bösartige Neubildung des Hypopharynx, nicht näher bezeichnet.

Bösartige Neubildung des zervikalen Ösophagus Speiseröhre. Bösartige Neubildung des thorakalen Ösophagus. Bösartige Neubildung des abdominalen Ösophagus. Bösartige Neubildung des Ösophagus, oberes Drittel. Bösartige Neubildung des Ösophagus, mittleres Drittel. Bösartige Neubildung des Ösophagus, unteres Drittel. Bösartige Neubildung des Ösophagus, mehrere Teilbereiche überlappend.

Bösartige Neubildung des Kardia Mageneingang. Bösartige Neubildung des Fundus ventriculi Magengrund. Bösartige Neubildung des Corpus ventriculi Magenkörper, Feld Thrombophlebitis. Bösartige Neubildung des Antrum pyloricum Magenvorhof. Bösartige Neubildung des Pylorus Magenpförtner. Bösartige Neubildung der kleinen Kurvatur des Magens, nicht näher bezeichnet.

Bösartige Neubildung des Magens, mehrere Teilbereiche überlappend. Bösartige Neubildung des Magens, nicht näher bezeichnet. Bösartige Neubildung des Zäkums Blinddarm. Bösartige Neubildung des Appendix vermiformis Feld Thrombophlebitis. Bösartige Neubildung des Colon ascendens. Bösartige Neubildung des Flexura coli dextra hepatica, Feld Thrombophlebitis.

Bösartige Neubildung des Colon transversum. Bösartige Neubildung des Flexura coli sinistra lienalis. Bösartige Neubildung des Colon descendens. Bösartige Neubildung am Rektosigmoid, Übergang. Sonstige näher bezeichnete Karzinome der Leber. Sonstige Karzinome der Leber, nicht näher bezeichnet. Bösartige Neubildung des extrahepatischen Gallenganges. Bösartige Neubildung der Ampulla hepatopancreatica Ampulla Vateri.

Bösartige Neubildung der Gallenwege, mehrere Teilbereiche überlappend. Bösartige Neubildung der Gallenwege, nicht näher bezeichnet. Feld Thrombophlebitis Neubildung des Ductus pancreaticus, Feld Thrombophlebitis. Bösartige Neubildung des endokrinen Drüsenanteils Feld Thrombophlebitis Pankreas.

Bösartige Neubildung sonstiger Teile des Pankreas. Bösartige Neubildung des Pankreas, nicht näher bezeichnet. Bösartige Neubildung des Larynx, mehrere Teilbereiche überlappend, Feld Thrombophlebitis. Bösartige Neubildung des Larynx, nicht näher bezeichnet.

Bösartige Neubildung der Trachea Luftröhre. Bösartige Neubildung der Pleura Brustfell. Bösartige Neubildung der Knochen des Hirn- und Gesichtsschädels. Bösartige Neubildung des Unterkieferknochens. Bösartige Neubildung der Wirbelsäule. Bösartige Neubildung der Rippen, Sternum und Klavikula. Bösartige Neubildung der Knochen und Gelenkknorpel, mehrere Teilbereiche überlappend. Bösartige Neubildung der Knochen und Gelenkknorpel, nicht näher bezeichnet.

Bösartiges Melanom sonstiger Feld Thrombophlebitis nicht näher bezeichneter Teile des Gesichtes. Bösartiges Melanom der behaarten Kopfhaut und des Halses. Bösartiges Melanom Feld Thrombophlebitis Haut, mehrere Teilbereiche überlappend. Bösartiges Melanom der Haut, nicht näher bezeichnet. Sonstige bösartige Neubildungen der Lippenhaut.

Sonstige bösartige Neubildungen der Haut sonstiger und nicht näher bezeichneter Teile des Gesichtes. Sonstige bösartige Neubildungen der behaarten Kopfhaut und der Haut des Halses. Sonstige bösartige Neubildungen der Haut des Rumpfes.

Sonstige bösartige Neubildungen der Haut, mehrere Teilbereiche überlappend. Sonstige bösartige Neubildung der Haut, nicht näher bezeichnet. Bösartige Neubildung des Bindegewebes und anderer Weichteilgewebe des Thorax. Bösartige Neubildung des Bindegewebes und anderer Weichteilgewebe des Abdomens. Bösartige Neubildung Ergänzungen von venösen Ulzera Bindegewebes und anderer Weichteilgewebe des Beckens, Feld Thrombophlebitis.

Bösartige Neubildung des Bindegewebes und Feld Thrombophlebitis Weichteilgewebe des Rumpfes, nicht näher bezeichnet. Bösartige Neubildung des Bindegewebes und anderer Weichteilgewebe, mehrere Teilbereiche überlappend. Bösartige Neubildung des Bindegewebes und anderer Weichteilgewebe, nicht näher bezeichnet. Bösartige Neubildung der Brustwarze und des Warzenhofes. Bösartige Neubildung zentraler Drüsenkörper der Brustdrüse.

Bösartige Neubildung oberer innerer Quadrant der Brustdrüse. Bösartige Neubildung unterer innerer Quadrant der Brustdrüse. Bösartige Neubildung des Recessus axillaris. Bösartige Neubildung der Brustdrüse, mehrere Teilbereiche überlappend. Bösartige Neubildung der Brustdrüse, nicht näher bezeichnet.

Bösartige Neubildung des Endozervix Gebärmutterhals.

Lecture 14. Thrombophlebitis

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