When differential diagnostics of this group is spent is painful, lesions of lungs, and others infectious disease implications are considered as clinical features actually.
The actinomycosis of lungs is one of clinical forms of an actinomycosis. Illness begins gradually. The intoxication at first is expressed weakly, a body temperature subfebrile. Tussis in the beginning dry, then starts to separate buy cipro 4mg a mucopurulent sputum, sometimes with a blood impurity. Prominent feature considers that the sputum has a smell of the earth and taste of copper. The infiltrate in a lung is enlarged from the centre to periphery, grasping gradually a pleura, a thoracal wall and a skin. On a corresponding half of breast there is a painful bagrovo-cyanotic tumescence, fistulas are formed, in pus separating from fistulas it is possible to find out druses . In this stage the diagnosis of an actinomycosis of lungs does not cause difficulties. It is much more difficult to diagnose during earlier period of illness, and it is very important for timely treatment (not treated patients at this form of an actinomycosis perish).
For diagnostics characteristic properties of a sputum matter the gradual beginning of illness, it, infiltrate augmentation in a lung. For diagnosis acknowledgement spend sputum research. In it it is possible to find out druses or only a mushroom. At sputum crops it is possible to allocate for a bloody agar or medium . Use also an intradermal allergy test with . Only positive and sharply positive reaction has diagnostic value. Weakly positive reactions can be observed and at other illnesses.
Aspergillosis. the aspergillosis form can proceed in the form of acute and chronic disease. Acute forms of an aspergillosis should be differentiated from a pneumonia. They are characterised by a high fever with the big daily allowances , repeated cold fits and sweats. Early there is a tussis with unit viscous mucopurulent or sputums. At some patients in a sputum it is possible to notice small greenish lumps at which microscopy clumps and mushroom dispute are visible. At patients the expressed dyspnea, accruing delicacy, a weight loss are observed, night sweats become perceptible. In lungs finely-bubbly wet rhonchuses, and at some patients a pleural rub are auscultated. the oval or roundish infiltrates inclined to disintegration are taped. Round cavities it is visible wide a shaft. In blood a leukocytosis, a moderate eosinophilia, an ESR it is raised. For diagnostics gravity of illness, its steady advance, characteristic radiological changes matter. For acknowledgement of the diagnosis crucial importance has detection of a mushroom of sort Aspergillus in a sputum. Are used also an intracutaneous test with specific allergen and with an antigen. A lethality at an aspergillosis over 20 %.
Brucellous pneumonia. The specific lesion buy rimonabant 4mg of lungs is observed at acute , is more rare - at the septiko-metastatic form. Stratification of a secondary infection at patients practically does not meet, therefore occurrence of a pneumonia in the patient acute testifies to development of a specific brucellous pneumonia. Is more often it develops at an aerogenic becoming infected (air-dust). Clinically brucellous pneumonia is characterised by duration of a current when 2 … 3 it is not taped special dynamics of physical and radiological data, fast effect does not give. In blood remain a leukopenia (characteristic for ), a neutropenia, a relative lymphocytosis. An ESR it is not changed. Gradually pneumonia signs disappear without any residual phenomena. Abscessing for a brucellous pneumonia uncharacteristically.

a pneumonia. The pneumonia caused Pneumocystis carrinii, meets seldom and basically at the persons weakened by any diseases (a leukaemia, a lymphogranulomatosis, neoplasms, etc.) or spent therapy (radial therapy, immunodepressants and so forth). Last years the case rate was considerably enlarged by a pneumonia in connection with AIDS diffusion.
the pneumonia begins gradually, there is a general delicacy, a dyspnea (at 91 % of patients), the fervescence is observed not at all patients (at 66 %), tussis more often dry, but can be productive, and at separate patients the blood impurity order ultram 4mg in a sputum becomes perceptible even. The cyanosis quite often develops, the liver and lien augmentation becomes perceptible (at 20 … 40 %), signs of the general intoxication are expressed moderately. The tachycardia, arterial pressure without essential changes is characteristic. Physical data at inspection of lungs are taped far not at all patients. Dry and wet rhonchuses can be auscultated. The cores for diagnostics are radiological changes which also develop gradually. Process almost always the bilateral. In the beginning moderate infiltration of a pulmonary tissue in the field of lung roots becomes perceptible, then the focal shades merging in large sites of inspissation which alternate with inflation sites develop, at rupture of the last (located ) the crescent pheumothorax can develop.
At a blood analysis the moderate leukocytosis - (10 … 15) - is characteristic. At sputum research the various microorganisms which have accumulated on an infection (bacteria, viruses, mushrooms) can be found out quite often. For diagnosis acknowledgement detection in washouts of bronchuses and more often in a tissue lungs and bronchuses is used. Some diagnostic value has improvement of a condition of the patient under the influence of antiparasitic therapy (Pyrimethaminum, Sulfadimezinum, Bactrimum). At sick of AIDS the answer to therapy comes more
Slowly, through 6 … 13 days after the beginning of therapy by Bactrimum and other preparations [En^elberg L. et al., 1984].
From other parasitogenic pneumonia it is necessary to note the respiratory [MA et al., 1984].
. This recently described disease proceeds usually in the form of a coloenteritis [Gerstoft J. et al., 1984], but at some weakened patients, mainly at AIDS, the original parasitogenic pneumonia similar on implications with can develop. Gradual development and a long current, process bilateral are characteristic, the body temperature raises to 38 … 39 ° and above. The diagnosis is based on originator detection in tissues of a lung with use of special colouring. The clinic a pneumonia is studied more not enough.
a pneumonia. Usually a pneumonia at virus illnesses (a flu, a measles, etc.) Happen virusno-bacteriemic. Purely virus pneumonia can be caused a cytomegalovirus. It develops at the persons weakened by various illnesses and spent therapy (a cancer, patients after transplantation of an osteal brain, transplantation of kidneys, AIDS). Proceeds in the form of the progressing pneumonia which is not giving in to vpxl 4mg therapy by antibiotics and . For differential diagnostics laboratory methods are used. The most simple is the cytologic research of deposits of a saliva, a sputum, urine, a spinal liquid. As the proof detection of cytomegalic cells («») serves. They represent large cells of the oval or roundish form. In a kernel the including surrounded light («an owl’s eye») becomes perceptible. Diameter of these cells reaches 25 … 40 microns. the pneumonia makes from 4 to 26 % of a pneumonia at persons with the weakened immune system [Masur et 1 „1985].
Initially-Aseptichesky pneumonia. Differential diagnostics of a chemical pneumonia is facilitated by anamnestic data (communication with gasoline, oxides of nitrogen and other toxic liquids), presence local (a combustion of a mucosa of respiratory tracts) and the general signs of a poisoning. The secondary bacteriemic infection (pneumococcal, staphylococcal, etc.) further can accumulate and there will be signs of infectious process. At an allergic pneumonia it is defined expressed in peripheric blood, it is possible to tap communication with any allergen. An aspiration pneumonia can sometimes develop and at the infectious diseases accompanied by paralyses (a botulism, etc.), but in such cases it will be complication.