钩端螺旋体病教程.pptVIP

Clinical Manifestations Type of pulmonary hemorrhage Pulmonary hemorrhage Clinical feature of the early phase (3-4 days) Clinical Manifestations Type of pulmonary hemorrhage 1． Type of mild hemorrhage Cough and hemoptysis A little bit of moist rale can be heard Dot-like or small nodular densities in chest X-ray Prognosis is fine if treatment is given in time Clinical Manifestations Type of pulmonary hemorrhage Clinical ManifestationsType of pulmonary hemorrhage 2、Type of severe hemorrhage Fever and other toxicemia symptoms get worse Breath and pulse get faster and faster; Pallor or cyanosed ; With more hemoptysis or even bleeding from mouth and nose; With more moist rale; Patchy or confluent densities can be seen on chest X-ray Confusion ,fear or even coma ! 神色惧变心发慌, 脉速气紧罗音现 Clinical ManifestationsType of pulmonary hemorrhage cyanosed coma Clinical ManifestationsType of pulmonary hemorrhage Causes of severe hemorrhage ① High virulence of the leptospira L.icterohemorrhagic ② No immunity to leptospira ③ Delayed treatment and no rest ④ Herxheimer reaction after penicillin therapy Clinical ManifestationsType of ieterohemorrhage Hepatic function impairment Jaundice Hepatomegaly Hemorrhage: Nose bleeding skin petechiae, purpura Hemoptysis, hematemesis, hematuria Kidney damage Proteinurin, Renal failure Leptospirosis can cause jaundice Clinical ManifestationsType of meningoencephalitis headache vomiting neck stiffness mental confusion Twitch,paralysis, brain edema, brain hernia, respiration failure CSF：pressure↑, protein↑ WBC↑,Glu↓, chloride is normal 2-3days Clinical feature in the early phase Clinical ManifestationsType of renal failure 1. Renal impairment can be found in all types of leptospirosis 2. However the type of renal failure is definitely uncommon Clinical ManifestationsComplication in period of recovery Late phase complications Late fever: recurrence of fever in the phase of convalescence R