Rickettsial pneumonia

qq77 — Sun, 23 Nov 2008 05:25:21 +0000

Rickettsial pneumonia. The lesion of lungs can develop at a number of rickettsioses, but practical value has only specific lesion of lungs at fever . In the beginning at this disease the pneumonia became perceptible so often, that fever named even a pneumorickettsiosis. Now it is established, that the lesion of lungs is observed far not in all cases of fever . Possibly, the pneumonia is characteristic for the cases of fever buy cipro 5mg resulting aerogenic infection, and at other ways of transfer (alimentary, transmissible, contact) illness proceeds without pneumonia development.
The lesion of lungs at fever is specific (rickettsial). Besides the pneumonic centres, at patients tracheobronchitis signs, as a rule, become perceptible, but never there are no symptoms of a lesion of the top respiratory tracts (a rhinitis, a pharyngitis, a laryngitis). The pneumonia is not unique implication of fever . However for this disease polymorphism of clinical semiology and its diagnostics (and consequently is characteristic, and definition of rickettsial character of a pneumonia) to other clinical signs also represents the big difficulties.
To think of possibility of a rickettsial pneumonia follows on the basis of set of the received clinical data. Physical implications of a rickettsial pneumonia same, as well as other pneumonia, it is possible to note only their radical character and involving in process of radical lymph nodes. The pneumonia remains is long, the involution of its semiology begins only after body temperature normalisation (the fever lasts usually to 2 ). Radiological changes remain usually during 6 .
From the general implications of fever it is possible to note the acute beginning, a fast fervescence (to 39 … 40 °), a headache, pains in eyeballs, retrobulbar pains, , a sleeplessness, the raised sweating. There can be a hyperemia of the person and a neck («a hood symptom»), a vasodilatation of scleras. The liver and a lien are early enlarged. The temperature curve with the big daily allowances and unlike a curve at others varies at a prescription of antibiotics, including Tetracyclinums a little. At a blood analysis become perceptible a leukopenia (less often ), the neutropenia, an ESR is moderately raised.
Differential diagnostics is based on following data. Epidemiological preconditions (stay in districts, contact to animals, the use of crude milk), the acute beginning, a high fever, early augmentation of a liver and a lien (3 are considered… 4th day of illness), unlike a canicola fever there is no icterus and a lesion of kidneys. The long current of a pneumonia, its combination to bronchitis signs are considered also. For diagnosis acknowledgement it is more often used with a specific rickettsial antigen.
Melioidosis. Pulmonary forms of a melioidosis can be observed in our country only as brought in cases at a becoming infected of the diseased in some districts of Southeast Asia (Vietnam, Laos, Kampuchea, etc.) . The lesion of lungs can acutely develop, right after infections (an incubation interval from 2 till 14 days), however more often the specific pneumonia develops after some months and even years after a becoming infected as a result of transition of the latent form of a melioidosis in the demonstrative. In these cases the lesion of lungs develops gradually. There is a general delicacy, a malaise, tussis with purulent, and sometimes and with a sputum. Delicacy accrues, the patient grows thin (loss of mass of a body reaches sometimes 10 … 15 kg). A fever more often wrong type with the big daily buy rimonabant 5mg allowances . There are pleural stethalgias. Tussis amplifies, the considerable quantity of a purulent sputum is quite often allocated. Radiological changes remind sometimes changes at a pulmonary tuberculosis. Process is more often localised in the top shares. In the beginning there are infiltrates. Then there can come their disintegration with formation of thin-walled cavities in diameter from 1 to 4 sm, is usually formed 2 … such 3 cavities, but can be and more.
For differential diagnostics a pneumonia great value has the epidemiological anamnesis (stay for last years in districts), subacute disease, a lesion of mainly top shares of lungs, tussis with a considerable quantity purulent or sputums, a weight loss, a fever of wrong type, formation of thin-walled cavities in lungs, negative results of research of a sputum on a tuberculosis micobacterium.

At chronic metastatic forms

qq77 — Sun, 23 Nov 2008 05:24:57 +0000

At chronic metastatic forms a pneumonia usually it is not observed.
For diagnostics of a brucellous pneumonia by the cores symptomatologies and original implication of the general intoxication are presence . The body temperature reaches usually 40… 41 °, however overall health of the patient remains rather satisfactory. At such fever patients can go, read books, play chess, etc. There are no expressed implications of the general intoxication (a headache, , weakness, etc.) . The order ultram 5mg temperature curve is characterised by the big daily allowances and waviness. Unlike a pulmonary tuberculosis at which the fever also is transferred well, the patient does not have euphoria, excitation. At inspection of the patient, besides physical signs of a pneumonia, the augmentation of all groups of lymph nodes becomes perceptible, to the extremity of 1st week from the disease beginning the sizes of a liver and a lien are enlarged. At transition in the septiko-metastatic form the locomotorium lesion (arthritises, periarthritises, bursitises and so forth), as a rule, becomes perceptible And peripheric nervous system (neuritises, polyneurites, radiculites). For acknowledgement of the diagnosis of a brucellous pneumonia by the most simple and in any hospital the intracutaneous test with a brucellin (assay ) which from the extremity of 1st week becomes positive and even sharply positive is accessible. It is necessary to consider only, that at persons, before inoculated against , assay also positive though its expression is less, than at patients . From methods the greatest diffusion was received by Right’s reactions and with a brucellous antigen.
the pneumonia is one of canicola fever implications, meets seldom. The lesion of lungs is caused as a result of their hematogenic dissimination. The pulmonary syndrome is most expressed on 3 … 5th day of illness and shown in semiology of an acute focal pneumonia and a bronchitis. At development of a hemorrhagic syndrome the sputum with blood can be allocated, and the pulmonary bleeding sometimes develops. Duration of changes in lungs to 10 … 14 days. During the second wave of a fever (last years it becomes perceptible seldom) the pneumonia caused by stratification of a secondary bacteriemic infection can develop. In this case the pneumonia is surveyed as complication.
Diagnostics character of a pneumonia, especially in an illness initial stage (to 3 … 5th day), causes sometimes difficulties. Acute, sometimes the sudden beginning, even at easy forms of illness the body temperature raises to 39 “With and above, the expressed symptoms of the general intoxication and on this background - pneumonia signs become perceptible. character of a pneumonia can be established not on features of a lesion of lungs, and on other implications of a canicola fever. Attracts attention disharmony of sharply expressed toxicosis and concerning small sites (centres) of a pneumonia. Early there are very strong pains unusual to another illnesses in muscles, especially in , sometimes complicating movement of patients. Appearance of the patient is characteristic: the person and a neck (« a hood symptom »), vessels of scleras , with 3 … at some patients can appear 4th day an icterus. From first days of illness the liver and lien augmentation becomes perceptible. At a serious current, and a pneumonia develop at serious forms is more often, the hemorrhagic syndrome can be observed. At a part sick (20 … 30 %) appear signs of a serous meningitis. Almost obligatory component of clinical semiology of a canicola fever is the lesion of kidneys. vpxl 5mg The quantity of urine decreases (sometimes to ), accrues the maintenance in filtrate nitrogen blood, at urine research erythrocytes, leucocytes, fiber, cylinders are taped. In blood - lejkotsitoz - (12 … 15) 109/l, ESR substantial increase. Detection at microscopy in a dark field can be acknowledgement of the diagnosis of a canicola fever. In an initial stage of illness they are found out in blood, and in the reconvalescence period - in an urocheras. Serological tests (microagglutinations, etc.) are used also. antiserum capacity increase is diagnostic 1:100 and above or better at research of didymous Serums.

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Rickettsial pneumonia

At chronic metastatic forms