最近审阅: 29 十月 2020
最近更新: 21 四月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 大量水样腹泻
  • 血容量不足的证据

其他诊断因素

  • 年龄<5 岁
  • 摄食贝类
  • 近期重度霍乱样疾病的家族史
  • 呕吐
  • 发热
  • 腹痛
  • 昏睡或昏迷

危险因素

  • 饮用被污染的水
  • 食用被污染的食物
  • 环境卫生较差
  • 近期出现的大雨和洪水
  • 胃酸分泌减少
  • O 型血
  • 营养不良
  • 艾滋病病毒 (HIV) 感染
  • 缺少母乳喂养

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 血清电解质
  • 血清尿素和肌酐
  • 血清乳酸
  • 动脉血气 (ABG)
  • 心电图
  • 粪便的暗视野/位相差显微镜检查
  • 快速粪便试纸检查
更多 首要检查

需考虑的检查

  • 粪便革兰染色
  • 对液体粪便、粪便悬浮液或直肠拭子进行粪便培养
  • 使用抗血清确定细菌的血清型
  • 抗菌谱(敏感)
  • 胸腔 X 线检查和腹部 X 线检查
更多 需考虑的检查

新兴检查

  • 粪便酶联免疫吸附测定(ELISA)试验
  • 粪便分子检测
  • 粪便环介导等温扩增 (loop-mediated isothermal amplification, LAMP) 试验
更多 新兴检查

治疗流程

撰稿人

Specialist in Infectious Diseases and Clinical Microbiology (UK)

Rega (Rettungsflugwacht/Air Rescue/Guarde Aérienne)

Switzerland

利益声明

ME declares that he has no competing interests.

Consultant Microbiologist 

Lister Hospital

East and North Hertfordshire NHS Trust

London

UK

利益声明

RL declares that she has no competing interests.

Dr Marcus Eder and Dr Rekha Lopez would like to gratefully acknowledge Dr Justin Green, a previous contributor to this topic.

利益声明

JG is employed by, and holds stock in, GlaxoSmithKline (GSK). GSK has had no involvement in the preparation of this document, and the views expressed are those of the author.

同行评议者展开全部内容

Professor

Department of International Health

Johns Hopkins Bloomberg School of Public Health

Baltimore

MD

利益声明

DS is an author of some studies referenced in this topic.

Scientist

Clinical Sciences Division

International Centre for Diarrhoeal Disease Research

Dhaka

Bangladesh

利益声明

NHA is co-author of a study referenced in this topic.

Registrar

Department of Pediatrics

University College of Medical Sciences

New Delhi

India

利益声明

JSK is the author of a reference cited in this topic.

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