Abstract:

To establish a scientific, standardized, and operable clinical laboratory pathway for infectious fever, and to address current problems such as blind selection of testing items, inappropriate testing timing, and inadequate multidisciplinary collaboration in clinical testing for infectious fever, the Clinical Microbiology Committee of the Shanghai Society for Microbiology and the Laboratory Medicine Branch and Molecular Diagnosis Branch of the Shanghai Medical Association jointly organized an expert panel. The panel integrated the current status of clinical diagnosis and treatment of infectious fever across different medical institutions, combined evidence-based medical evidence with the characteristics of clinical practice in China, and referred to existing consensuses and guidelines (such as the 2017 Expert Consensus on the Diagnosis and Treatment of Fever of Unknown Origin), as well as relevant domestic and international regulations and standards, to formulate the Expert Consensus on the Clinical Testing Pathway for Infectious Fever. The revision of this consensus unified the standards for the clinical testing pathway for infectious fever, standardized diagnosis and treatment behaviors, optimized allocation of medical resources, improved the quality of diagnosis and treatment, and addressed practical problems such as coexistence of overuse and underuse of testing items, poor multidisciplinary collaboration, and disconnection of testing services among medical institutions at different levels. This article interprets the revision background, implementation difficulties, and clinical significance of the consensus. It focuses on newly added contents such as the differential diagnosis and clinical feature definition of infectious fever, precise testing strategies for high-risk populations, hierarchical testing strategies, and application of novel laboratory diagnostic technologies. Additionally, it highlights core topics including hierarchical testing strategies, optimal selection of special pathogen detection technologies, individualized diagnosis and treatment for high-risk populations, and multidisciplinary collaboration mechanisms. Meanwhile, this article discusses current challenges in the implementation of the consensus, including unbalanced allocation of medical resources, inadequate multidisciplinary collaboration, and limitations in the application of new technologies. It also provides an outlook on the continuous improvement of the consensus with advances in testing technologies and promotion of progress in the diagnosis and treatment of infectious diseases, aiming to provide practical guidance for clinicians and laboratory personnel in medical institutions at all levels, further improve the diagnostic efficiency and accuracy of infectious fever, and promote standardized development of clinical diagnosis and treatment.

Key words: Infectious fever, Clinical testing pathway, Precision diagnosis, Multidisciplinary collaboration