~Teachingcenter的醫學筆記~

較少見但也較常被忽略的不明熱成因：
(但有的時候又因為常有報告被忽略，反而會被認真檢查？)

1. 感染Infections (有*表示TOCC特別重要，尤其travel history)
   • 腹腔內或牙科的膿瘍Intra-abdominal or Dental abscesses
   • 非洲蜱咬熱(立克次體感染)African tick bite fever*
   • 阿米巴肝膿瘍Amebic liver abscess*
   • 人粒細胞無形體病Human granulocytic anaplasmosis/ehrichiosis*
   • 巴貝斯蟲症Babesiosis*
   • 布魯氏桿菌病(地中海弛張熱)Brucellosis*
   • 血管濾泡性淋巴結增生(angiofollicular lymph node hyperplasia) Castleman's disease
   • 屈公熱、登革熱(蚊子傳播)Chikungunya、Dengue *
   • 慢性活動性肝炎Chronic active hepatitis
   • 細菌培養陰性之心內膜炎Culture-negative endocarditis
   • 巨細胞病毒感染Cytomegalovirus
   • 椎間盤炎Discitis
   • 副睪炎Epididymitis
   • 吸蟲症Fascioloiasis*
   • 絲蟲症Filariasis*
   • 淋病性關節炎Gonococcal arthritis
   • 單純皰疹病毒腦炎Herpes simplex encephalitis
   • 感染性單核球症Infectious mononeucleosis
   • 內臟利什曼原蟲症(Kala azar)Visceral leishmaniasis*
   • 菊地氏(菊池)病Kikuchi's disease
   • 拉薩熱Lassa fever*
   • 鉤端螺旋體症(水災)Leptospirosis*
   • 萊姆氏病Lyme disease*
   • 骨髓炎Osteomyelitis
   • 攝護腺炎Prostatitis
   • 腎盂腎炎Pyelonephritis
   • 子宮蓄膿Pyometria or Pyometra
   • Q熱Q fever (Coxiella burnetii)*
   • 回歸熱(回歸熱疏螺旋體)Relapsing fever (Borrelia recurrentis)*
   • 風溼熱Rheumatic fever
   • (鼻)竇炎Sinusitis
   • 弓漿蟲症Toxoplasmosis
   • 傷寒熱Typhoid fever*
   • 結核病Tuberculosis
   • 惠氏病(腸源性膠脂質營養吸收不良，起因於Tropheryma whippelii感染)Whipple's disease
   • 茲卡病毒(蚊)Zika virus*
2. 惡性腫瘤Malignancies
   1. 白血球缺乏性白血症Aleukemic leukemia、白血病Leukemia
   2. 心房黏液瘤Atrial myxoma
   3. 大腸癌Colon cancer
   4. 肝細胞癌或肝轉移癌Hepatocellular carcinoma or other tumors metastatic to the liver
   5. 卡波西是肉瘤(須加驗HIV)Kaposi's sarcoma
   6. 肺癌Lung cancer
   7. 淋巴癌(尤其是非霍奇金氏淋巴瘤)Lymphoma, especially non-Hodgkin's
   8. 多發性骨髓瘤Multiple myeloma
   9. 骨髓增生不良徵候群Myelodysplastic syndromes
   10. 腎細胞癌Renal cell carcinoma
   11. 惡性肉瘤Sarcoma
3. 全身性發炎性疾病Systemic inflammatory diseases
   1. 過敏性肉芽腫血管炎Allergic granulomatous angiitis (Churg-Strauss Syndrome)
   2. 抗磷脂抗體症候群Antiphospholipid syndrome
   3. 貝賽氏症Behçet's disease
   4. 冷凝球蛋白血症Cryoglobulinemia
   5. 巨細胞動脈炎Giant cell arteritis
   6. 壞死性肉芽腫性多發血管炎Granulomatosis with polyangiitis (formerly Wegener's disease)
   7. 肉芽腫性肝炎Granulomatous hepatitis
   8. 過敏性血管炎Hypersensitivity vasculitis
   9. 發炎性腸炎Inflammatory bowel disease
   10. 主動脈炎Panaortitis
   11. 多發性結節性動脈炎Polyarteritis nodosa
   12. 反應性關節炎Reactive arthritis (formerly Reiter's syndrome)
   13. 結節病Sarcoidosis
   14. 史笛兒氏症Still's disease
       1. 可侵犯多處器官的發炎性疾病，也是成人不明原因發燒的重要病因
       2. 其臨床三合症(triad)：持續性高燒、易於消褪的皮膚紅疹、關節痛或關節炎
       3. 其他症狀還有喉嚨痛、淋巴結腫大、肝脾腫大、或其他內臟器官侵犯
   15. 全身性紅斑狼瘡Systemic lupus erythematosis
   16. 高安氏(大動脈)血管炎Takayasu's arteritis
4. 其他Miscellaneous
   1. 川崎氏症Kawasaki disease
   2. 神經性或皮膚性體溫調節不良Disorders of temperature regulation (neurologic and dermatologic)
   3. 藥物引起Drug fever
      1. 抗生素(尤其磺胺類或盤尼西林)Antimicrobials (especially sulfonamides and penicillins)
      2. 抗癲癇藥Antiepileptic
      3. 抗甲狀腺用藥Antithyroid
      4. NSAIDs
   4. 環境(聚合物煙塵熱)Environmental (metal and polymer fume fevers)
   5. (詐病)人為發燒Factitious fever
   6. 家族性地中海熱Familial Mediterranean fever
   7. 抗精神藥物惡性症候群Neuroleptic malignant syndrome
      1. 症狀：意識狀況改變(譫妄、木然、昏迷)、肌肉僵直、高燒(可超過攝氏40度)、自律神經功能異常
      2. 常見於haloperidol、fluphenazine、clozapine
   8. 週期性發燒Periodic fever
   9. 肺栓塞Pulmonary emboli
   10. 後腹腔血腫Retroperitoneal hematomas
   11. 慢性疲勞症候群Chronic fatigue syndrome
   12. 甲狀腺炎Thyroiditis