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（体温≥37.5℃）
- 呼吸频率增加
- 收缩压低
- 不适感
- 恶心/呕吐
- 头痛
- 咽痛/咽炎
- 结膜炎
- 胸痛/咳嗽
- 肌痛
- 耳聋（感觉神经性）
- 面部水肿
- 出血
其他诊断因素
- 腹痛
- 腹泻
- 意识模糊及格拉斯哥昏迷量表评分改变或癫痫发作
- 积液
危险因素
- 职业暴露
- 在疾病流行地区生活/工作，或从这些地区归来
- 接触感染者的体液
- 屠宰和/或食用啮齿类动物的肉
- 生物恐怖主义
诊断性检查
首要检查
- 逆转录聚合酶链反应 (RT-PCR)
- 血清学
- 快速诊断侧流免疫层析检测
- 疟疾快速诊断试验
- 针对伤寒的血培养
需考虑的检查
- 肾功能
- 血清电解质
- 血乳酸/动脉血气 (ABG) 分析
- 全血细胞计数 (FBC）
- 凝血功能检查
- 肝功能检测
- 胸部 X 线检查
- 尿液分析
- 血培养
- 腰椎穿刺：
- 腹部超声
治疗流程
潜在暴露
疑似感染或有症状
撰稿人
作者
Catherine Houlihan, MBChB, PhD
Clinical Lecturer in Infectious Diseases/Virology
University College London
London
UK
利益声明
CH declares that she has no competing interests.
鸣谢
Dr Catherine Houlihan would like to gratefully acknowledge Dr Ron Behrens, a previous contributor to this topic.
利益声明
RB has provided expert testimony to the courts, on behalf of the Crown, regarding Q fever. RB has been a paid member of the Advisory Board for Takeda regarding Dengue vaccine. He has been a paid member of the Advisory Board for Valneva UK regarding Ixiaro, a vaccine for Japanese encephalitis.
同行评议者
John S. Schieffelin, MD, MSPH
Assistant Professor of Medicine & Pediatrics
Tulane University School of Medicine
New Orleans
LA
利益声明
JSS is a paid reviewer and author of articles on UpToDate.
Michael Brown, BA, BM, BCh, FRCP, PhD, DTM&H
Consultant Physician
Hospital for Tropical Diseases
University College London Hospitals
London
UK
利益声明
MB is Clinical Lead of the Hospital for Tropical Diseases, a contributing partner to the PHE Imported fever service that co-ordinates testing of samples from UK patients for viral haemorrhagic fevers.
Stephen Gluckman, MD
Professor of Medicine
Perelman School of Medicine at the University of Pennsylvania
Philadelphia
PA
利益声明
SG declares that he has no competing interests.
鉴别诊断
- 疟疾感染
- 伤寒感染
- 埃博拉病毒感染
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