Hemorrhagic fever

Hemorrhagic feverHEMORRHAGIC FEVER with renal syndrome hemorrhagic nefrosonefrit) is an acute viral natural focal disease, occurring with intoxication, fever, a kind of renal syndrome and hemorrhagic manifestations. Etiology, pathogenesis. The causative agent belongs to the group of arboviruses. In a feverish period of the disease the virus is in the blood causing toxic damage to the nervous system and severe hemorrhagic purpura nervosa. Characterized by loss of kidney acute renal failure. The symptoms for. The incubation period is from 11 to 23 days. The disease begins acutely. Appears fever (38-40'), headache, insomnia, myalgia, photophobia. Face, neck, upper sections of the trunk hypermonogenic, vessels injected sclera. The 3-4-th day of the disease the condition worsens, there are abdominal pain, vomiting, hemorrhagic syndrome (hemorrhagic rash, nosebleeds, bleeding at the injection site and others). Pain in the abdomen and lower back can become unbearable, the amount of urine decreases, its relative density is low (up to 1,004), anuria may occur, increasing azotemia, acute renal failure can lead to uremic coma. After lowering the body temperature to normal the patient's condition is not improving. Growing tokicos (nausea, vomiting, hiccups), disturbed sleep, sometimes appear meningeal symptoms. Characterized by the absence of jaundice, increase in liver and spleen. May occur spontaneous rupture of the kidney. Transporting the patient during this period should be very careful. In the process of healing the symptoms gradually diminish the long-term remains asthenia. After this period, the typical polyuria (up to 4-5 l/day), which lasts up to 2 months. Diagnosis is based on characteristic clinical symptoms; specific methods of laboratory diagnostics has not yet entered into wide practice. To differentiate you from leptospirosis, dengue Ku, pseudotuberculosis. Treatment. Etiotropic therapy no. Recommend bed rest, lacto-vegetarian diet, vitamins. Assign prednisolone from 50 to 120 mg/day. After normalization of body temperature gradually reduce the dose. Course duration 8-15 days, In the first days/enter 5% glucose solution or isotonic sodium chloride solution with the addition of 1% solution of potassium chloride (50 ml per 1 l of isotonic solution), 5% ascorbic acid solution (20 ml/ day) and 4% sodium hydrogen carbonate solution (50 ml per 1 l of solution). For day to enter 1-1,5 l In the absence of arterial hypotension in phase oliguria appoint mannitol or furosem/1D (lasix). Recommended lavage with 2% solution of sodium bicarbonate and siphon enemas. If pain is severe appoint pantopon. At increasing kidney failure patient should be extracorporeal hemodialysis. The prognosis is good; sometimes there are severe complications (rupture of the kidney, uremic coma, meningoencephalitis), which threaten the life of the patient. Ability to work recovering slowly, sometimes after 2 months. Prevention. Control of rodents, protecting their products. Patients are isolated. In a place where patients, is the current and final disinfection..

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