小结
定义
病史和体格检查
关键诊断因素
- 典型年龄组(<15 岁或>25 岁)
- 暴露于感染者
- 前往疫区旅行
- 未接种疫苗/未全程接种
- 咽痛
- 吞咽困难或发声困难
- 呼吸困难
- 哮吼性干咳
- 假膜形成
- 颈部肿胀
- 皮肤病变
- 呼吸受损
其他诊断因素
- 低热
- 喘鸣
危险因素
- 未接种疫苗的个体
- 疫苗接种不完全的个体
- 接触感染者
- 前往疫区旅行
- 皮肤破溃
- 卫生差、拥挤和贫困
诊断性检查
首要检查
- 细菌学培养和显微镜检查
需考虑的检查
- 产毒性 Elek 试验
- 白喉抗体
- 多聚酶链式反应 (PCR)
治疗流程
呼吸道和皮肤白喉病例的密切接触者
呼吸道白喉
皮肤白喉
无症状携带者
撰稿人
作者
Walid Abuhammour, MD, FAAP, FIDSA
Professor of Paediatrics
Al Jalila Children's Specialty Hospital
Dubai
UAE
利益声明
WA declares that he has no competing interests.
Sarmad Farook Yahya Alhamdani, MBCHB, CABP, FICMS
Consultant Paediatrician
Al Jalila Children's Specialty Hospital
Dubai
UAE
利益声明
SFYA declares that he has no competing interests.
Nida Yousef, MD
Pediatric Cardiology Fellow
Advocate Hope Children's Hospital
Chicago
IL
利益声明
NY declares that she has no competing interests.
同行评议者
William A. Petri, Jr, MD, PhD, FACP
Chief and Professor of Medicine
Division of Infectious Diseases and International Health
University of Virginia Health System
Charlottesville
VA
利益声明
WAP declares that he has no competing interests.
George Y. Wu, MD, PhD
Professor of Medicine
University of Connecticut Health Center
Farmington
CT
利益声明
GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.
Linda S. Nield, MD
Associate Professor of Pediatrics
West Virginia University School Of Medicine
Morgantown
WV
利益声明
LSN declares that she has no competing interests.
鉴别诊断
- 化脓性链球菌咽炎
- 急性会厌炎
- 传染性单核细胞增多症
更多 鉴别诊断指南
- 成人免疫程序:2022 年美国针对年满 19 岁人群的建议
- 儿童和青少年免疫程序:2022 年美国针对不超过 18 岁人群的建议
更多 指南患者教育信息
DTP 疫苗(白喉、破伤风、脊髓灰质炎)
DTaP 疫苗(白喉、破伤风、脊髓灰质炎和百日咳)
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