小结
定义
病史和体格检查
关键诊断因素
- 咳嗽
- 流感样疾病
- 呼吸困难
- 发热
- 呼吸音减弱
- 呼吸急促
其他诊断因素
- 呕吐、腹泻
- 意识状态改变
危险因素
- 亚洲谱系 A 型(H7N9) 病毒的环境暴露
- 与感染者密切接触
- 接触 A 型(H7N9) 病毒的实验室工作人员
诊断性检查
首要检查
- FBC 和分类计数
- 肝功能检查 (LFT)
- 胸部 X 线检查
- 脉搏血氧测量测定法
- 痰液革兰氏染色
- 痰菌培养和血培养
- 逆转录聚合酶链反应 (RT-PCR)
需考虑的检查
- 病毒培养
治疗流程
确诊或拟诊病例的密切接触者
疑似、拟诊或确诊感染
撰稿人
作者
Jake Dunning, BSc (Hons), MBBS, MRCP, PhD
Consultant in Infectious Diseases and General (Internal) Medicine
Tuberculosis; Acute Respiratory, Gastrointestinal, Emerging and Zoonotic Infections; and Travel Health (TARGET) Division
National Infection Service
Public Health England
London
UK
利益声明
JD declares that he has no competing interests.
Timothy M. Uyeki, MD, MPH, MPP
Chief Medical Officer
Influenza Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention
Atlanta
GA
利益声明
TMU is a member of the Guideline Development Group for the World Health Organization Standard Guidance for the Clinical Management of Severe Influenza. TMU is a co-chair for the Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza.
鸣谢
Dr Jake Dunning and Dr Timothy M. Uyeki would like to gratefully acknowledge Dr Justin R. Ortiz, a previous contributor to this topic.
利益声明
JRO is a member of the International Council on Adult Immunization and the scientific community for the Global Influenza Hospitalization Surveillance Network.
同行评议者
Rob Fowler, MDCM, MSc
Senior Scientist
Sunnybrook Health Sciences Centre
Toronto
Ontario
Canada
利益声明
RF declares that he has no competing interests.
Nelson Lee, MD, FRCP(Lond.), FRCP(Edin.)
Professor
Division of Infectious Diseases
Faculty of Medicine and Dentistry
University of Alberta
Edmonton
Alberta
Canada
利益声明
NL declares that he has no competing interests.
Michael Ison, MD, MS
Professor
Division of Infectious Diseases
Division of Organ Transplantation
Northwestern University Feinberg School of Medicine
Chicago
IL
利益声明
MI declares that he received research support, paid to Northwestern University, from Beckman Coulter, Chimerix, and Gilead; is a paid consultant for Celltrion, Chimerix, Farmark, Genentech/Roche, Toyama/MediVector, Seqirus, and Shionogi; and is a member of the DSMB for GlaxoSmithKline and Shionogi.
鉴别诊断
- 2019 冠状病毒病（COVID-19）
- 社区获得性肺炎
- 非典型肺炎
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- 针对严重人类疾病相关或可能导致严重人类疾病的甲型禽流感病毒感染禽鸟接触者的流感抗病毒化学预防临时指南
- 流感病毒感染所致重症疾病的临床管理指南
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