小结
定义
病史和体格检查
关键诊断因素
- 全身性症状
- 淋巴结炎(腺鼠疫)
- 咯血(肺鼠疫)
- 腹泻(耶尔森菌病)
- 腹痛(耶尔森菌病)
其他诊断因素
- 胸膜炎性胸痛(肺鼠疫)
- 呼吸困难(肺鼠疫)
危险因素
- 接触跳蚤(鼠疫)。
- 居住或者到疫区旅行(鼠疫)
- 接触感染动物(鼠疫)
- 生物恐怖主义(鼠疫)
- 幼儿(耶尔森菌病)
- 摄入生的或未全熟的猪肉制品(耶尔森菌)
- 接触鼠疫患者(鼠疫)
- 铁过载综合征(耶尔森菌病)
- 慢性肝病、糖尿病、酒精中毒(耶尔森菌病)
诊断性检查
首要检查
- 血培养(鼠疫)
- 腹股沟淋巴结穿刺液培养(腺鼠疫)
- 痰培养(肺鼠疫)
- 脑脊液培养(败血症性鼠疫)
- 咽拭子样本培养(咽鼠疫)
- 抗原检测(鼠疫)
- 白细胞计数(鼠疫)
- 胸部 X 线检查(肺鼠疫)
- 粪便培养(耶尔森菌病)
需考虑的检查
- 血清学检查(鼠疫或耶尔森菌病)
- 聚合酶链反应(鼠疫)
治疗流程
肺鼠疫或败血症性鼠疫:非妊娠成人和儿童
腺鼠疫或咽鼠疫:非妊娠成人和儿童
肺鼠疫、败血症性鼠疫、腺鼠疫或咽鼠疫:妊娠
脑膜炎型鼠疫
耶尔森菌病
撰稿人
作者
John Williams, MRCP, DTM&H, Dip HIV Med
Consultant Infectious Diseases Physician
Department of Infection and Travel Medicine
The James Cook University Hospital
Middlesbrough
UK
利益声明
JW declares that he has no competing interests.
同行评议者
Vladimir L. Motin, PhD
Professor
Pathology/Microbiology and Immunology
University of Texas Medical Branch
Galveston
TX
利益声明
VLM declares that he has no competing interests.
Waleed Javaid, MD, FACP, FIDSA
Associate Professor
Medical Director of Infection Control
Infectious Disease
Department of Medicine
SUNY Upstate Medical University
Syracuse
NY
利益声明
WJ declares that he has no competing interests.
Alistair Leanord, BSc, MBChB, MD, DTM&H, FRCPath
Consultant Microbiologist
Microbiology Department
Southern General Hospital
Glasgow
UK
利益声明
AL declares that he has no competing interests.
Janak Koirala, MD
Associate Professor of Medicine
Division of Infectious Diseases
Department of Internal Medicine
Southern Illinois University School of Medicine
Springfield
IL
利益声明
JK declares that he has no competing interests.
鉴别诊断
- 革兰阴性菌脓毒症
- 细菌性肺炎
- 猫抓病
更多 鉴别诊断指南
- CDC 黄皮书:国际旅行健康信息——耶尔森菌病
- CDC 黄皮书:国际旅行健康信息——鼠疫
更多 指南患者教育信息
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成人腹泻
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