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钩端螺旋体病

最后审阅: 1 Nov 2024
最后更新: 09 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
  • 弛张性高热
  • 头痛
  • 肌痛
  • 结膜充血
  • 肌肉压痛
完整详情

其他诊断因素

  • 寒战或寒颤
  • 腹痛
  • 恶心或呕吐
  • 腹泻
  • 乏力
  • 厌食
  • 畏光
  • 眼痛
  • 颈项强直
  • 咳嗽
  • 呼吸困难
  • 胸痛
  • 咯血
  • 少尿或多尿
  • 心律失常
  • 淋巴结肿大
  • 脾肿大
  • 肝肿大
  • 黄疸
  • 淋巴结肿大
  • 精神状态改变
  • 麻疹样皮疹
完整详情

危险因素

  • 接触(直接或间接)受感染动物的尿液
  • 在疫区居住或到疫区旅行
  • 在近期发生水灾的地区居住或到近期发生水灾的地区旅行
  • 参加水上运动
  • 生活条件差/卫生设施缺乏
完整详情

诊断性检查

首要检查

  • 全血细胞计数 (FBC) 和分类计数
  • 尿液分析
  • 显微镜凝集试验 (MAT)
  • 酶联免疫吸附试验 (ELISA)
  • 聚合酶链反应 (PCR)
  • 暗视野检查
  • 血培养
  • 脑脊液 (CSF) 培养
  • 心电图 (ECG)
  • 胸部 X 线检查
  • 肝功能检查 (LFT)
  • 结合胆红素
  • 代谢指标
  • 血清胰酶
  • 脑脊液 (CSF) 分析
完整详情

需考虑的检查

  • 尿液培养
  • 肾脏活检
  • 肺活组织检查
  • 染色方法
  • 乳胶凝集试验
  • 蛋白质印迹法
  • 定量 PCR
完整详情

新兴检查

  • 侧流测定
  • 细胞因子

治疗流程

急症处理

轻度疾病

中重度病情者

撰稿人

作者

John Fournier, MD

Clinical Fellow

Infectious Disease Section

Yale School of Medicine

New Haven

CT

利益声明

JF declares that he has no competing interests.

Albert I. Ko, MD

Professor of Epidemiology and Medicine

Department Chair

Epidemiology of Microbial Diseases

Yale School of Public Health

New Haven

CT

利益声明

AIK serves as an expert panel member for the Reckitt Global Hygiene Institute and a Board of Directors member for the American Society of Tropical Medicine. He has received grants from Zoetis and has patents which have been awarded and submitted for use in developing diagnostics and vaccines for leptospirosis.

鸣谢

Dr John Fournier and Dr Albert I. Ko would like to gratefully acknowledge Dr Nilmarie Guzman, a previous contributor to this topic.

利益声明

NG declares that she has no competing interests.

同行评议者

Carmen Isache, MD

Assistant Professor of Medicine

Infectious Disease Division

University of Florida College of Medicine

Jacksonville

FL

利益声明

CI declares that she has no competing interests.

Andreas Jansen, MD, DTM

Scientific Officer

Robert Koch Institute

Department for Infectious Disease Epidemiology

Gastrointestinal Infections

Zoonoses and Tropical Infections Unit

Berlin

Germany

利益声明

AJ declares that he has no competing interests.

Sean V. Shadomy, DVM, MPH

Epidemiologist

Bacterial Zoonoses Branch

DFBMD/NCZVED/CCID

Centers for Disease Control and Prevention

Atlanta

GA

利益声明

SVS declares that he has no competing interests.

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