北美学到的一些取得正确诊断的有益思路Helpfultipstoachieve.PDFVIP

北美学到的一些取得正确诊断的有益思路 Helpful tips to achieve accurate diagnoses learnt from North America 黄彦云 Yanyun Huang 兽医；硕士；博士；北美兽 BAgr (Vet Med), MAgr (Vet Path), 医病理协会认证病理师 MSc, PhD, DACVP 加拿大平原诊断服务 副诊断 Associate Director of Diagnostics 总裁及病理师 and Anatomic Pathologist Prairie Diagnostic Services Inc. 萨斯卡切温大学客席教授 Adjunct Professor Department of Veterinary Pathology University of Saskatchewan #1 注意用多种方法验证一个诊断 Use more than one method to confirm a diagnosis 案例Case • 哺乳仔猪，急性死亡。有一些有腹泻。死亡率约1%。Suckling pigs, acutely died. Some degree of diarrhea. Mortality ~1%. • 你会怎样做？What will you do? • PCR: PED -, TGE -, DCV -, Rotavirus A + • 这是轮状病毒引起的腹泻死亡吗？Is this rotavirus diarrhea and death? 案例Case 肠毒性大肠杆菌 Enterotoxigenic E. coli (ETEC) /acp-medicine/infections-due-to-escherichia- coli-and-other-enteric-gram-negative-bacilli-part-1/ #1 注意用多种方法验证一个诊断 Use more than one method to confirm a diagnosis • 以上面的病例为例，很多北美临床医生会要求实 验室做In this case, many vets in North America will order ： • 病理组织学Histopathology • 肠道细菌培养 （配以F4和F18凝集试验）Culture of the guts (with F4 and F18 agglutination tests) (如果没有 凝集试验，PCR也可以 if agglutination test not available, PCR can work) • PCR: PED, TGE, rotavirus • 加上临床观察，大体病变观察，一共是7种方法 With clinical and gross observation, 7 methods are involved to achieve the diagnosis of ETEC #