感染症診療の基本中の基本 - town.chizu.tottori.jp

1 60 CRP /dl CRP CRP CRP CRP , , , , , neck flexion test, jolt accentuation , , , , CVA tenderness CVA tenderness , ICU 60 30 37 C 37 C - - - - - - 20 , 130/60, 73, 18/.

2 A B C E L - - .. , , A , B , C , D CNS 47 My teaching for many years has been that the emergency room physician should be uncomfortable with the diagnosis of gastritis or gastroenteritis.

3 Cope , , , 47 , , , 20 / , / 124/78mmHg 98/ 40 C C , , , , , , CVA tenderness(-), BS( ), Murphy(-), McBurney(-) , mass , WBC 8300, Hb , PLT TP , ALB , T-BIL AST 139, ALT 79, LDH 524, AMY 55, CPK 561, GLU 324 BUN 42, Cr Na 124, K , Cl 85, HbA1c 26 / , 95% X Chlamydophila pneumoniae X Cr, BUN.

4 HIV 15 54 A&B , , , , , , X .. 66 , 38 C 38 39 C 38 C 117/67 88/ 16/ 98 C (-) (-) (-) (-) (-) , , , (-) (-) (-) WBC 10700 TP Glu.

5 415 Hb GOT 11 Na 137 Ht GPT 11 K PLT 18 ALP 229 Cl 99 LDH 188 BUN AMY 69 Cr CPK 111 Ca , , 10 , 60 11 fascia , Fournier's gangrene A , 60 17 39 C , PL.

6 20 HCC Vibrio vulnificus 63 WBC 15600 PLT GOT 159, GPT 115, ALP 1646, LDH 677 , BUN 50, Cr 13 .. 12 , , TSS A Vibrio vulnificus Aeromonas hydrophilia , TEN , Stevens-Johnson SJS , EM SJS 38 C.

7 TEN SJS 10% SJS 10% TEN , ST , , 27 , , 8 ( ) X .. Lemierre , CT , , DIC Ludwig angina , 65 , 50.

8 , B 50 .. CTRX VCM CTRX VCM CTRX CTRX % CTRX VCM CTRX % CTRX , B CTRX 100% CTRX ABPC AMPC 12g/ g 50 CTRX , B CNS CNS CT 30 VDRL.

9 FTA-ABS HIV X , PDD, , , , , PCR HSV, VZV, CMV , , VDRL, FTA-ABS, , , , TbPCR, ADA , 50 X 13 14 10 28 , , .. 600 / .. 12 .. 24 500 / .. 28 C , X , VDRL HIV, , , , SLE FTA-ABS T.

10 Pallidum , , , SLE, WBC 5100, RBC 435 , Hb , MCV , Ht , PLT TP , Alb , T-Bil , AST 85, ALT 127, ALP 249, LDH 487, -GTP 120 ChE 156, BUN , Cr , Glu 163, CPK 83 Na 135, K , Cl 97 (-), (-), (-) CT CT Dr.. 15 , killer , , , , , , , , , , FUO FUO - , , , - - , CT 2.