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Ag etiol Et Patog

Epid Transmit Cai

Antrax Bacillus antracis f-Bacillaceae vegettiv/sporulat Bacilaerob,gr+.imobil sporulat. Spori inh-tract res inf - fagocitati de macrof -GLhilari si mediastinaligermineaza-f.veget produc toxinemediastinita necrozanta hemoragic Animale bolnave Diseminarea aerosoli Cut,pulm,dig,mening Cut-edematoasa, buloasa, erizip, carbunculoasa

Tularemia Francisella tularensis

Pesta Yersinia pestis f-enterobacteriace Cocobacil gr-, imobil Cocobacil grTransmisa la om prin inocularea cut-muc cu singe Transmitere la om prin purici9contact sau lichide tis sau intepaturi direct cu lichide/tes animal,inhalarea de pic septice . Intepaturi de purici,caprioara,tintari,capuse Aerosoli, cut , digestiva Ulcero-ganglionara,oculogangl,tifoidica,faringiana

De la rozatoare purici Contact direct/inhalare

CLINICA Incubatie 1-7z - 6-8sapt Prodrom(Febra, mialgii,tuse,oboseala,disc thoracic) De STARE (dupa amelioarare-ind resp (dispnee,stridor , cianoza, dur tor-edem tor/git) RAD-largirea mediastinala+/- revarsat pleural Meningita=50% EVOLUTIE-rap progr-soc-deces Mortalit fara tr -100% Epidem/ Clinic

Lab

Rozeola-papula- vezicula- antracit- crusta mare cafenie. In debut si in stareaprofundare , lipsa durerii, edem pal, vibratie masiva(pelteaua), Stefanski +, t-810z, GL mariti -Proba itracut cu antraxina-24/48 ore + 8 mm si mai mult. -Ig anticarbunoase Limfocitoza

3-5z (1-14z) Debut(acut, febra, frisoane, transpire, mialgii, cefalee, angina), eliminaro conjunct STARE(t,↓ponder,tuseneprod, dur tor,dispnee,hemoptizie rara) RAD-mod min Netratata-IR-af multiorganic-sepsis(deces) EVOLUTIE-usoara,nespecifica,rapid progresiva

DIAGNOSTIC GL hipertrofiati ( bubonul tularemic)submandibul, cervicali. Buboni bine delimitati , putin dolofi , deasupra nu sunt modificati , limfadenita, H/S Meg, depistarea anginei tularemice- (f . angina-bubonica). Amigdalita unilaterala( ulcero-necrotica) t-intrmitent 3 sapt.

Leucopenie, limfocitoza, monocitoza, VSH

2-5z Forma-bubonica/ cut-bubonica/ cutanata Debut(t↑,frisoanr,cef,mialgii,tuse expectsepsis. LIMBA DATA CU VAR SPUTA HEMORAGICA (APOASA,PURULENTE) RAD-bronhopneumon EVOLUTIE –semne dig gretur,varsaturi,diaree -IR-sepsis Mortalit-60% fara tr Macula-papula, vezicula-pustula-ulcer, GL mariti –BUBONUL, durerosi,, solitare sau multiple, (MI, axilare, cervicale)puroi , verde –galbui. Soc toxicoinfectios. Af pulmonarapneumonie pestoasa. Semnele meningiene Leucocitoza, trpenie,

Etiologic

dd

Prof

Bacterioscopia-din vezicule, la marginea crutel.Gen- sputa, mase vomitive, urina, LCR. -Imunofluorescenta Bacteriologic Biologica -ELISA-toxemia a 2-3 z -PCR-secretii nazale(diag rapid-24)

Penicilina-2MU la 2 ore+ Streptomicina Ciprofloxacina-400mg i/v la 8-12ore,dur30-60z (Ciprinol) Chirurgic –extirparea contraind Inf virale,pneumonii bact,anevrizm disecant de aurta

Profilaxie specifica

-Bacteriologic- Spalatura faringiana,sputa,aspir gastrica,singe -Biologic – pier dupa 4-14 z -Proba alergica-APA EDEM INFILTRAT D-MAI MARE 0.5 CM IFdirecta,imunohistochimice,Ag,microaglutinare, PCR Serologic-r de aglutinare(1/100)/ RHAI (1/500)ELISA TRATAMENT Streptomicina-1g 2ori/zi Gentomicina-5mg/kg i/v 10z Flurochinolone (ciprofloxacins, Ofloxacin, doxofloxacin, levofloxacin) S tifoidice, pneumonie et virala

Bacteriologic-exudat din af cutanata, puroi, sputa , LCR. Serologic-RHAI, RIA( AC-IgM), ELISA (IgM,IgG)( 2 SAPT), ( AgF1imunoenzimatic)Ac titru mai mare 4 ori -PCRag cauzal

Streptomicina-1g/zi Gentamicina-5mg/kg 10-14z Doxiciclina,ciprofloxacina,cloramfenicol Complic-s de coagulare intravasc diseminat,purpura,achimoze,gangrena extramitatilor, detresa resp.ins multiorg,soc

Diagnostic HVA VIRUSOLOGIC MF-ultima sapt per de incubatie /preicterica/ 1sapt -icterice SEROLOGIC anti -HVA IgM (1s de la deb)anti HVA IgG (inf support)

alte

Leucopenie,limfo, monocitoza

TRATAMENT

f.usoare- reg la pat/dieta Dotoxifiere(glucoza,reopoliglicina) F colestetice-ca la HVB

HVE

HVB Contacte Ag HBs-purtator/+infective Ag HBe-replicare,infective AND-polim-repicativ,infect antiHBe anti-HBcor IgM anti HBcor IgG

Bilirubina,alat,asat,ldh Teste de coagulare(protrombina)

HVD Coinfectie 1Preicterica AgHBs/AgHBe

HVE