传染病学：3伤寒（英文）.ppt

Remittence stage The fourth week of illness stage Body temperature appear remittment-fever， gradually declining, with the improvement of pathogenic condition. Patients are emaciated and weak, and liable to have complications. Restoration stage The 4th or 5th week of illness stage Bacteria are eliminated, the syndromes disappear gradually, and organizations recover gradually. Patients will recover completely in about a month. Atypical typhoid fever Slight type Abortive type Protraction type Ambulatory type Fulminating type Characteristic in children Slight type and abortive type often happen Vomiting and diarrhea are common hepatosplenomegaly Complications of prominent bronchial pneumonia and bronchitis mostly Characteristic in elder Low temperature Atypical clinical manifestation Serious cardiovascular system and nervous system symptoms With the complications of bronchitis and heart dysfunction Recovery slowly, high fatality rate Laboratory test The counts of WBC are not high, the majority are less than 5000/dl The counts of Acidocytes decrease or disappear. Difference between paratyphoid fever and typhoid fever Caused by Paratyphoid Salmonella Short incubation period，8~10 days Mild pathogenic condition Short course（2~3 weeks） Appearance of acute gastroenteritis initially pyemia type in Paratyphoid C recurrence and recrudecence Complication Enterorrhagia Enterobrosis Haematolysis toxic urine syndroma Diagnosis Clinical diagnosis Sustained fever over seven days, the temperature rising like ladder, febris, relative infrequent pulse, typhoid face (apathia), rose rash, splenohepatomegalia, the count of WBC is not high Sustained fever for over seven days ， the count of WBC is not high, and acidocytopenia or even acidocyte disappearance Early patients? Mild patients? Untypical patient? Laboratory diagnosis Bacteria culture Blood, stool, urine, bone marrow culture Typhoid fever serum agglutination test （Widal’s reaction） Widal’s negative reaction can not