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目的 分析以“发热原因待查”收入感染科患者的病因构成、诊断方法,总结临床诊断思路,为诊断发热患者提供科学的临床思维方法.方法 回顾性分析2002年1月至2009年12月由门诊初诊为“发热原因待查”收住解放军第三○二医院的368例患者的最终病因诊断,诊断手段以及其病因与性别、年龄及热程之间的关系.结果 368例患者中112例(30.4%)因热程短或热度低,在2周内明确诊断或痊愈,其中107例(95.5%)经检查明确诊断,5例(4.5%)获痊愈而病因不明.明确诊断者的病因中感染性疾病104例(92.9%),血液病2例,药物热1例,无肿瘤及恶性疾病.其余256例符合FUO,其中241例明确诊断,确诊率为94.1%.其病因中感染性疾病193例(79.38%),风湿免疫病32例(13.40%),血液病或肿瘤16例(9.28%),未能明确病因的15例(17.09%).FUO患者中男性124例,其中感染性疾病95例(76.6%),风湿免疫病10例(8.1%),血液病及肿瘤10例(8.1%),病因不明9例(7.3%).女性132例,其中感染性疾病98例(74.2%),风湿免疫病22例(16.6%),血液病及肿瘤6例(4.6%),病因不明6例(4.6%).年龄分布:≤14岁10例,15～20岁37例,21～50岁110例,51～60岁48例,61以上51例;热程＜4周者83例,其中感染性疾病74例,＞8周者63例,其中感染性疾病21例,风湿免疫病20例.结论 以发热原因待查收入感染科的发热患者有部分经询问病史、查体和常规检查短期内可确诊,其病因以感染为主.约70%符合FUO,感染性疾病、风湿免疫病及肿瘤性疾病是主要病因.临床诊断时应综合考虑性别、年龄、热程等因素.“,”Objective To explore the etiology, diagnostic methods and procedures for patients with fever of unknown origin (FUO) at department of infectious diseases. Methods A total of 368 FUO patients admitted to department of infectious diseases from 2002 to 2009 were retrospectively reviewed. The correlations of etiologies and diagnostic methods with gender, age and progress of fever were analyzed.Results Among them, 112 (30.4%) cases were recognized in 2 weeks ( diagnosis, n = 107; recovery with unknown causes, n =5). A final diagnosis was established in 241 (94.1%) from the remaining 256 FUO patients (124 males, 132 females). Among them, the causes were infectious diseases (n=193),rheumatologic/autoimmune diseases (n=32) and hematological diseases / tumors (n=16). The etiologies were infectious diseases (n=95), rheumatologic/autoimmune diseases (n=10 ), hematological diseases /tumors ( n = 10 ) and unknown etiology ( n = 9 ) in males respectively; infectious diseases ( n = 98 ),rheumatologic diseases ( n =22), hematological diseases or tumors ( n = 6) and unknown etiology ( n=6) in females respectively. Age of patients: ＜ 14 yr ( n = 10), 15 - 20 yr ( n = 37), 21 - 50 yr ( n = 110),51 -60 yr (n =48) and ＞ 61 yr (n =51). Thermal process was ＜ 4 weeks (n =83) including 74infe ctious diseases cases and ＞ 8 weeks ( n =63), including infectious diseases (n=21 ) and rheumatologic disease (n = 20). Conclusion Some FUO outpatients may be promptly confirmed by history taking, physical examination and routine examinations. The major cause is infection. Other causes of FUO are infectious diseases, rheumatological / autoimmune diseases and hematological diseases / tumors. For the diagnosis of FUO patients, gender, age and thermal process should be considered.