(一)疾病概述 (Identification)
鉤端螺旋體病(Leptospirosis)是由鉤端螺旋體(Leptospira interrogans)感染產生的感染症,是熱帶、亞熱帶地區常見的人畜共通感染病,在台灣其被歸類於第四類法定傳染病。鉤端螺旋體為細桿狀螺旋型,兩端呈現鉤狀具內鞭毛的螺旋體,可經由傷口感染幾乎所有的哺乳類動物,包括野生及家畜動物。主要宿主有老鼠、犬隻、豬、牛、馬、羊等動物。動物感染鉤端螺旋體後,造成腎臟慢性感染,並且由尿液大量排菌,再經由尿液污染水及土壤,進而感染人類。當人們工作(農民、下水道工程、礦工、屠夫),或野外活動時可經由皮膚及黏膜傷口因接觸到受動物尿液污染的土壤或水而得病,少部份因直接接觸動物及其組織而感染。目前為止發現至少有25個血清群約277個血清型,感染過某血清型鉤端螺旋體後,還是有可能受其他不同血清型的感染。
- Jul 27 Tue 2010 22:06
鉤端螺旋體感染
- Mar 25 Thu 2010 20:50
值班記事-Renal Failure After Oral Sodium Phosphate for Colonoscopy
腎臟不好的病人 千萬不要用fleet soda(sodium phosphate)來做colon prepare呀
昨天值班遇到一個病人突然喘起來 baseline BUN:80,Cr:5
- Jan 05 Tue 2010 19:56
ACC 2009: ACTIVE-A: Clopidogrel and Aspirin Reduce CV Events in Atrial Fibrillation
ACTIVE-A: Cardiovascular End Points by Treatment Group
End point | Clopidogrel, n (%/y) | Placebo, n (%/y) | Relative risk (95% CI) | p |
---|---|---|---|---|
Major vascular events | 832 (6.8) | 924 (7.6) | 0.89 (0.81-0.98) | .01 |
Stroke | 296 (2.4) | 408 (3.3) | 0.72 (0.62-0.83) | <.001 |
MI | 90 (0.7) | 115 (0.9) | 0.78 (0.59-1.03) | .08 |
Strokes of ischemic or unknown origin were reduced significantly, and hemorrhagic stroke was increased, although not significantly.
- Dec 10 Thu 2009 20:55
還是相信病人所說的話吧!!
- Dec 02 Wed 2009 20:24
氣管內管置放-Endotrachea intubation
- Dec 02 Wed 2009 10:47
Consious disturbance鑑別診斷小口訣
Causes of consious disturbance included:AEIOU TIPS
A:Alcohol(overdose / withdraw),Ammonia,Adrenal insufficiency
- Dec 01 Tue 2009 17:07
Chemotherapy induced nausea and vomiting