Acute respiratory viral diseases 15

and duration) than the previous one (typhoid, ornithosis, mononucleosis, etc.): when the subsequent wave is caused by adding of a complication,the revertive interrelations are observed, i.e. the second wave is more expressed, than the first one (epidemic paratitis, flu, etc.).

The relapsing fever (/. recidiva) in contrast to the recurrent fever (the regular alternating of the fever waves and apyrexy) is characterized by a relapse (usually one) of the fever which develops in different terms (from 2 days to one month and more) after the termination of the first temperature wave (typhoid, ornithosis, etc.). The relapses develop in some of the patients (10-20 %). In this connection if the relapse has an important diagnostic value, the absence of it does not eliminate a possibility of the mentioned above diseases at all.

Each infectious disease can have different variants of a temperature curve, among which some are more frequent, they are typical for this or that nosological form. Sometimes they even allow to diagnose the disease quite accurately (tetrian fever, etc.).

The duration of a feveris is an important value for the differential diagnosis. A number of diseases are characterized by a short-term fever (herpangina, acute shigellosis, etc.). And if, for example, the fever lasts more than 5 days, it already allows to eliminate such frequently encountered diseases,as flu and other acute respiratory virus diseases, angina (certainly, if there are no complications).

On the contrary, the long-term fever (more than a month) is observed rather seldom and only in some infectious diseases which lend to the lingering or chronic flow (brucellosis, toxoplasmosis, visceral leishmaniasis, tuberculosis). Thus the grade and characteristic of a temperature curve and the duration of a fever allow to differentiate certain groups of infectious diseases, among which the differential diagnosis is based on other parameters.

For the differential diagnosis the interval between the onset of a fever and the appearance of organic lesions is particularly important. In some infectious diseases this period is less than 24 hours (herpetic infection, scarlatina, rubella, meningococcemia), in others it lasts from 1 up to 3 days (measles, shigellosis), and, at last, in a number of diseases it lasts more than 3 days (typhoid fever, virus hepatitis).

The nature and level of the infectious diseases rate also matters. For example, any feverishness during the epidemic of flu suggests a possibility of flu. The indication to the contact with the people sick with measles, scarlatina, water-pox, rubella and other droplet infections is important. These data are compared to the terms of an incubation period. Other epidemiological data (the stay on the territory which is endemic on malaria, and other diseases) also matters.

For the differential diagnosis the change of a temperature curve under the influence of etiotropic medications is important. Delagilum stops malarial attacks, in endemic typhus the temperature quickly becomes normal after the reception of tetracyclines and others. There are a number of peculiarities of the fever

Date: 2014-12-21; view: 985