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拉沙热

最后审阅: 21 Oct 2024
最后更新: 24 Aug 2023

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
完整详情

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
完整详情

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
完整详情

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
完整详情

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
完整详情

治疗流程

初步治疗

潜在暴露

急症处理

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 has been on a scientific advisory board for Valneva regarding Chikungunya vaccines.

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.

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