Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2
Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2
LEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2es from asymptomatic or subclinical to self-limited systemic illness (approximately 90% of patients) to life-threatening illness with jaundice, renal failure (oliguric or nonoliguric), myocarditis, hemorrhage (particularly pulmonary), and refractory shock. Clinical presentation may be monophasic or Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2biphasic. Classically described biphasic leptospirosis has an acute septicemia phase, usually lasting 1 week, when Leptospira organisms are present inEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
blood, followed by a second immune-mediated phase that does not respond to antibiotic therapy. Regardless of its severity, the acute phase is charactLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2istinct clinical findings include notable conjunctival suffusion without purulent discharge (30%-99% of cases) and myalgia of the calf and lumbar regions (4O%-1OO% of cases). Findings commonly associated with the immune-mediated phase include fever, aseptic meningitis, and uveitis; between 5% and 10 Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2% of Leptospira-infected patients are estimated to experience severe illness. Severe manifestations include any combination of jaundice and renal dysfEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
unction (Weil syndrome), pulmonary hemorrhage, cardiac arrhythmias, and circulatory collapse. The estimated casefatality rate from severe illness is 5LEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2n is frequent, especially in settings of endemic infection.EtiologyLeptospirosis is caused by pathogenic spirochetes of the genus Leptospira. Leptospires are classified by species and subdivided into more than 250 antigenically defined serovars and grouped into serogroups on the basis of antigenic r Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2elatedness.EpidemiologyLeptospirosis is among the most globally important zoonoses, affecting people in resource-rich and resource-limited countries iEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
n urban and rural contexts. It has been estimated that approximately 868,000 people annually worldwide are currently infected (range, 327,000-1,520,00LEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2estic animals, primarily rats, dogs, and livestock (eg, cattle, pigs), that can shed organisms asymptomatically for years. Leptospira organisms excreted in animal urine can remain viable in moist soil or water for weeks to months in warm climates. Humans usually become infected via entry of leptospi Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2res through contact of mucosal surfaces (especially conjunctivae) or abraded skin with contaminated environmental sources. Unusually, infection may beEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
acquired through direct contact with infected animals or their tissues, infective urine or fluids from carrier animals, or urine-contaminated soil orLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2ns of high endemicity likely encounter Leptospira organisms commonly during routine activities of daily living. People who are predisposed by occupation include abattoir and sewer workers, miners, veterinarians, farmers, and military personnel. Recreational exposures and clusters of disease have bee Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2n associated with adventure travel; sporting events, including triathlons; and wading, swimming, or boating in contaminated water, particularly duringEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
flooding or following heavy rainfall. Being submerged in or swallowing water during these activities is a common historical finding. Person-to-personLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2ebrospinal fluid during the early septicemic phase (first 7-10 days) of illness and from urine specimens 14 days or more after336LEPTOSPIROSISillness onset. Specialized culture media are required but are not routinely available in most laboratories. Leptospira organisms can be grown on Leptospira se Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2misolid medium (ie, Ellinghausen-McCullough-Johnson-Harris) from blood culture bottles used in automated systems within 1 week of inoculation. HoweverEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
, isolation of the organism may be difficult, requiring incubation for up to 16 weeks, and the sensitivity of culture for diagnosis is low. For these LEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2can be measured by commercially available immunoassays. However, these assays have variable sensitivity according to regional differences of the various Leptospira species and increases in antibody titer may not be detected until more than 10 days after onset, especially if antimicrobial therapy is Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2initiated early. Antibody increases can be transient, delayed, or absent in some patients. Microscopic agglutination, the gold standard serologic testEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
, is performed only in reference laboratories and requires seroconversion demonstrated between acute and convalescent specimens obtained at least 10 dLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2for detection of Leptospira DNA in blood and urine have been developed but are only available in research laboratories.TreatmentIntravenous penicillin is the drug of choice for patients with severe infection requiring hospitalization; penicillin has been shown to be effective in shortening duration Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2of fever as late as 7 days into the course of illness. Penicillin G decreases the duration of systemic symptoms and persistence of associated laboratoEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
ry abnormalities and may prevent development of leptospiruria. As with other spirochetal infections, a Jarisch-Herxheimer reaction (an acute febrile rLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2erapy. Parenteral cefotaxime, ceftriaxone, and doxycycline have been demonstrated in randomized clinical trials to be equal in efficacy to penicillin G for treatment of severe leptospirosis. Severe cases also require appropriate supportive care, including fluid and electrolyte replacement. Patients Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2with oliguric renal insufficiency and pulmonary hemorrhage syndrome require prompt dialysis and mechanical ventilation, respectively, to improve cliniEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
cal outcome. For patients with mild disease, oral doxycycline has been shown to shorten the course of illness and decrease occurrence of leptospiruriaLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2ycline and can be used as an alternative in patients for whom doxycycline is contraindicated (eg, pregnant women).Image 77.1Photomicrograph of leptospiral microscopic agglutination test with live antigen (Clarkfield microscopy technique). Leptospirosis is a common global zoonotic disease of humans a Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2nd several warm-blooded animals, especially in subtropic regions of the world, caused by the spirochete bacteria Leptospira. Courtesy of Centers for DEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
isease Control and Prevention/Mrs M. Gatton.LEPTOSPIROSISImage 77.2Scanning electron micrograph of Leptospira interrogans strain RGA. Courtesy of CentLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2nt male that shows the generalized vasculitis caused by this infection.Image 77.4Photomicrograph of kidney tissue, using a silver staining technique, revealing the presence of Leptospira bacteria. Courtesy of Centers for Disease Control and Prevention/Martin Hicklin. MD.338LEPTOSPIROSISImage 77.5Pho Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2tomicrograph of liver tissue revealing the presence of Leptospira bacteria. Humans become infected by swallowing water contaminated by infected animalEbook Read book Atlas of pediatric infectious diseases (3/E): Part 2
s or through skin contact, especially with mucosal surfaces, such as the eyes or nose, or with broken skin. The disease is not known to be spread fromLEPTOSPIROSIS77LeptospirosisClinical ManifestationsLeptospirosis is an acute febrile disease with varied manifestations. The severity of disease range Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2ate in the interstitium and focal denudation of tubular epithelial cells (hematoxylin-eosin, original magnification x100). B. Immunostaining of fragmented leptospire (arrowhead) and granular form of bacterial antigens (arrows) (original magnification x158). Meites E, Jay MT, Deresinski s, et al. Ree Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2merging leptospirosis, California. Emerg Infect Dis. 2004; 1O(3):4O6-412.LISTERIA MONOCYTOGENES INFECTIONSGọi ngay
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