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<title>ケースで学ぶ不明熱の診断学 | 株式会社文光堂</title>


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<meta name="description" content="2012年刊行『この1冊で極める不明熱の診断学』の姉妹編．「症例から診断にいたる実例が知りたい」という読者の要望に応え，不明熱診断の過程を実症例に基づいて解説した１冊．原因不明の発熱に対する診断の過程を，①Review of Systems（ROS），②Problem List，③鑑別診断，④確定診断・除外診断，⑤最終診断，⑥不明熱エキスパートの診断・治療戦略，という構成で明快に解説．さらに要所要">

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		<h1 class="catchCopy">不明熱の診断はこう行うべし！さまざまな症例からエキスパートの思考過程が手にとるようにわかる！</h1>
		

		<h1 class="title">ケースで学ぶ不明熱の診断学<span class="version"></span></h1>
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					監修：野口善令（名古屋第二赤十字病院副院長）
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					編集：横江正道（名古屋第二赤十字病院総合内科部長）
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">2012年刊行『この1冊で極める不明熱の診断学』の姉妹編．「症例から診断にいたる実例が知りたい」という読者の要望に応え，不明熱診断の過程を実症例に基づいて解説した１冊．原因不明の発熱に対する診断の過程を，①Review of Systems（ROS），②Problem List，③鑑別診断，④確定診断・除外診断，⑤最終診断，⑥不明熱エキスパートの診断・治療戦略，という構成で明快に解説．さらに要所要所に「不明熱エキスパートの頭の中」を挟むことによって一層リアルに思考過程を追体験できるようにした．研修医，内科医必携の１冊．</section><section class="preface">序　文<br><br>　本書は，2012年に上梓した前作『この1冊で極める 不明熱の診断学』の姉妹編である．<br>前作では，発熱＋αの「＋α」に注目して，原因不明の発熱にアプローチする方法をなるべくわかりやすく言語化し解説した．発熱＋αとは，「発熱自体にのみ注目していては診断はつかない，発熱以外の手がかりに目を向けないといけない」ことをコンセプト化したものである．<br>　幸いなことに「不明熱」の診断に悩む多くの臨床医の助けになったようで好評を得たが，いただいたフィードバックの中に，症例から鑑別診断のプロセスを解説して診断に至る実例がもっとほしいというリクエストがかなりあった．そこで，不明熱の診断の思考過程を症例ベースで解説する企画としてまとめたのが本書である．<br>　何を疑い，どんな情報を集め，最終診断に至るかの思考プロセスをわかりやすく理解してもらう工夫として，本書では以下の構成を採用した．<br>・病歴，身体所見<br>・不明熱エキスパートの頭の中<br>・Review of Systems（ROS）を行う<br>・検査結果<br>・発熱患者の状況をProblem List にまとめよう<br>・鑑別診断は？<br>・確定診断・除外診断を進めよう（追加検査）<br>・最終診断<br>・不明熱エキスパートの診断・治療戦略<br>・『この1 冊で極める 不明熱の診断学』のここを読もう！<br>　症例は，すべて名古屋第二赤十字病院総合内科で実際に経験したものであるが，個人情報保護のために，全体像が失われない程度に情報を省略したり脚色したりした部分があることをお断りしておく．<br>　前作と同じく，本書が「原因がわからない発熱だ．不明熱だ．」とすぐに思考停止する状態から脱却する助けになり，ひとりでも多くの患者さんに良いアウトカムをもたらすことができれば著者一同の大きな喜びである．<br>　それでは，「不明熱」の症例帖をお楽しみください．<br><br>　2018年3月<br>　著者を代表して　野口善令</section><section class="indexes">カラー口絵<br>第I章　総論<br>　“不明熱”の診断とは<br>　①緊急性，アウトカム，頻度／②緊急性の＋α／③リスクファクターの＋α／④症状・身体所見の＋α／⑤手がかりに乏しいのも＋α／⑥疾患の全体像に着目する／⑦不明熱診断の概略マップ<br>第II章　各論：症例検討編<br>　ケース1 　killer sore throat<br>　ケース2 　脾摘後の発熱といえば…<br>　ケース3 　仮診断は胆道感染症…？<br>　ケース4 　男性の尿路感染？<br>　ケース5 　痛いのは中，外？<br>　ケース6 　腰痛のレッドフラッグ！<br>　ケース7 　痛くて腫れているのは＋αの手がかり<br>　ケース8 　抗菌薬に反応しない発熱は…（その1）<br>　ケース9 　抗菌薬に反応しない発熱は…（その2）<br>　ケース10　肝硬変患者の発熱…<br>　ケース11　伝染性単核球症にしては経過が長い…<br>　ケース12　知っていれば典型的だが…<br>　ケース13　免疫抑制剤は＋α？<br>　ケース14　長引く肺炎には要注意！<br>　ケース15　貧血でも熱は出る？<br>　ケース16　やはり血液培養は基本<br>　ケース17　慢性の高CRP血症<br>　ケース18　診断がつかずに状態が悪化…<br>　ケース19　問診の裏に潜むもの<br>　ケース20　一見解決したようにみえて…<br>　ケース21　組織診断，どこをとる？<br>　ケース22　診断基準の2本の柱…<br>　ケース23　鑑別診断のうちで残るのは？<br>　ケース24　血培，血培，血培…<br>　ケース25　足先が紫色に…<br>　ケース26　アメーバの既往はあるが…<br>　ケース27　何年もの時を経て診断できた！<br>　ケース28　fever &amp; rashのcritical！<br>　ケース29　消化器症状が目立つ肺炎と言えば…<br>　ケース30　手がかりに乏しいのが＋α…<br>　ケース31　commonな発熱の鑑別疾患が除外されたあとは？<br>　ケース32　敗血症性ショックの原因は？<br>　ケース33　fever ＆ rashの鑑別診断<br>　ケース34　血液培養のその先を考える<br>　ケース35　発熱＋痙攣？<br>　ケース36　＋αは咽頭痛<br>　ケース37　関節炎から考える<br>索引</section></article>
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