Today in medical practice there is a rather large number of patients diagnosed with "subfebrile condition of unknown origin". These patients, unfortunately, are forced to visit various specialists for many years, while remaining without an accurate and correct diagnosis. Often, such patients are not completely examined, but sent immediately to a neurologist who, in some cases, establishes hyperthermia of the central genesis.
Today in medicine, subfebrile is called a fever increase for more than three weeks not higher than 37.9 ° C. It is quite difficult to find out the cause of the condition.
A rise in temperature of more than 38.3 ° C and maintaining it for more than three weeks in the absence of diagnosing the cause after a week of intensive search is characterized as a fever of unclear genesis.
This condition can accompany any infection. However, difficulties in diagnosing often occur with sporadic, uncharacteristic for the terrain or atypical diseases occurring atypically. Much attention is paid to anamnesis, including epidemiological.
Fever of unknown origin can accompany abscesses in the abdominal cavity (retroperitoneal, subdiaphragmatic, pelvic). Their likelihood increases with the presence of surgery, trauma, laparoscopic or gynecological manipulation in the anamnesis.
The fever of an unclear genesis often occurs as a result of a lesion of tuberculosis. Diagnostic complexity is characteristic of extrapulmonary form with negative samples. Of great importance is the examination of lymph nodes, their biopsy.
Hospital fever of unknown origin is often caused by hospital infections (staphylococcus, Pseudomonas aeruginosa). Therefore, when diagnosing, it is necessary to take into account the structure of hospital infections in a separate institution.
Against AIDS, developing fever in 80% is due to the accompanying infection, in 20% is associated with lymphomas. With the development of pathology, provoked by the herpes virus, Epstein-Barr, CMV difficulties in diagnosing occur in elderly patients.
Infertility of unknown origin.
This diagnosis is made, if after a thorough examination of women and men, the cause was not identified. An exception method is used.
The diagnosis is made for women on condition that:
- normal hormonal background;
- regular ovulation, which is confirmed by functional diagnostic tests;
- free passableness of the fallopian tubes ;
- Absence of pathology of the uterus;
- unidentified endometriosis;
- Positive postcoital test;
- Absence of antispermal bodies in blood serum.
It should be noted that the diagnosis can not be made without diagnostic laparoscopy. This is due to the fact that individual causes of infertility (endometriosis, for example) are detected only in the process of this study.
A man is diagnosed with normal spermogram, negative MAP test (study of the presence of antispermic bodies), provided that a sufficiently frequent sexual intercourse (during the period of ovulation especially) and attempts of spouses to conceive for at least a year.
Patients with diagnosed infertility of unknown origin are divided into two groups.
The first should include people who have no problems with fertility.
The second group includes patients who have an objective cause of the condition. However, even with the use of modern diagnostic measures, it is not possible to identify it, or it is unknown to specialists. In many cases, this diagnosis indicates the imperfection of the research capabilities of modern medicine.