最近审阅: 25 十月 2020
最近更新: 29 五月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 发热/盗汗
  • 咳嗽
  • 脓毒性休克
  • 区域淋巴结炎/腮腺炎
  • 不愈合性皮肤溃疡或脓肿
  • 无明显临床病灶的菌血症
  • 下运动神经元颅神经麻痹(特别是颅神经 VII 和 VIII)
  • 弛缓性下肢轻瘫

其他诊断因素

  • 呼吸短促
  • 腹痛/腹泻
  • 排尿困难
  • 尿潴留
  • 意识状态改变
  • 霉菌性假性动脉瘤

危险因素

  • 职业/娱乐休闲环境暴露
  • 糖尿病
  • 有害的饮酒
  • 慢性肾病
  • 恶性肿瘤和免疫抑制治疗
  • 地中海贫血
  • 囊性纤维化和其他慢性肺部疾病
  • 生物恐怖主义

诊断性检查

首要检查

  • 血液培养
  • 痰培养
  • 尿液培养
  • 来自于皮肤病变、脓肿、淋巴结炎、内部脓肿(如肝脓肿)引流液的脓液/拭子培养
  • 胸部 X 线检查 (CXR)
  • 腹部和盆腔 CT ± 胸部 CT
  • 腹部/盆腔超声
更多 首要检查

需考虑的检查

  • 在 Ashdown 选择性肉汤/琼脂中培养咽拭子
  • 在 Ashdown 选择性肉汤/琼脂中培养直肠拭子
  • 脑脊液培养
  • CSF 显微镜检查以及 CSF 蛋白质和葡萄糖含量
更多 需考虑的检查

治疗流程

撰稿人

Professor in Medicine

Northern Territory Medical Program

Royal Darwin Hospital

Head of Tropical and Emerging Infectious Diseases

Menzies School of Health Research

Charles Darwin University

Darwin

Australia

利益声明

BJC is the author of several references cited in this monograph.

David A.B. Dance

Senior Clinical Research Fellow/Consultant Microbiologist

Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit

Vientiane

Laos

Centre for Tropical Medicine and Global Health

University of Oxford

Oxford

Honorary Professor

Faculty of Infectious and Tropical Diseases

London School of Hygiene and Tropical Medicine

London

UK

利益声明

DABD is the author of several references cited in this monograph. DABD has acted as a consultant to Soligenix Inc. and has worked with InBios on the evaluation of diagnostic tests for melioidosis.

同行评议者展开全部内容

Director of Microbiology

Townsville Hospital

Townsville

Australia

利益声明

RN declares that he has no competing interests.

Professor of Medicine

Faculty of Medicine

Khon Kaen University

Khon Kaen

Thailand

利益声明

PC declares that he has no competing interests.

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