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重症监护病房中的伤寒和肠热病

Typhoid and Enteric Fevers in Intensive Care Unit.

作者信息

Ray Banambar, Raha Abhijeet

机构信息

Department of Critical Care Medicine, Sum Ultimate Medicare, Bhubaneswar, Odisha, India.

出版信息

Indian J Crit Care Med. 2021 May;25(Suppl 2):S144-S149. doi: 10.5005/jp-journals-10071-23842.

Abstract

Enteric fever (typhoid and paratyphoid)is caused by and . It is spread by fecal-oral route, largely through contamination of water and foodstuff. Developing countries are the worst affected. It takes 7 - 21 days from ingestion of the organism to manifestation of symptoms which are generally Fever, relative bradycardia, and pain abdomen. Hepatosplenomegaly, intestinal bleeding, and perforation are the features at various stages of the disease. The bacteria invade the submucous layer and proliferate in the Payer's patches. Blood culture is the gold standard for diagnosis but it is only rarely positive. Fluroquinolones, cephalosporins, and azithromycin are antibiotics of choice. There is increasing evidence of the development of resistance to all antibiotics. sepsis, though uncommon, can occur. Intestinal perforation, peritonitis, and secondary sepsis are complications that may require intensive care unit management. Ray B, Raha A Typhoid and Enteric Fevers in Intensive Care Unit. Indian J Crit Care Med 2021;25(Suppl 2):S144-S149.

摘要

伤寒(伤寒和副伤寒)由[具体病菌名称缺失]引起。它通过粪-口途径传播,主要是通过水和食物污染。发展中国家受影响最为严重。从摄入病菌到出现症状需要7至21天,症状通常为发热、相对心动过缓和腹痛。肝脾肿大、肠道出血和穿孔是疾病不同阶段的特征。细菌侵入黏膜下层并在派尔集合淋巴结中增殖。血培养是诊断的金标准,但阳性率很低。氟喹诺酮类、头孢菌素和阿奇霉素是首选抗生素。对所有抗生素产生耐药性的证据越来越多。败血症虽然不常见,但可能发生。肠道穿孔、腹膜炎和继发性败血症是可能需要重症监护病房管理的并发症。雷·B、拉哈·A《重症监护病房中的伤寒和肠热症》。《印度重症监护医学杂志》2021年;25(增刊2):S144 - S149。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e30/8327799/c787b1a1fb2b/ijccm-25-S144-g001.jpg

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