Infectious diseases

joining the elements of the eruption can be of a diagnostics value.

Enanthema - the rashes on the mucous - can be observed less often in infectious diseases and is less important for the differential diagnostics. However, in a number of illnesses the changes of the mucous are rather informative at their identification at the initial stage. The lesions of the oral cavity and eyes conjunctiva are of the greatest practical value.

The most essential characteristic symptoms of the infectious diseases are the hyperadenosises, icterus, catarrh of respiratory tract, diarrhea, meningeal symptoms.

Hyperadenosis is the result of the frequent involvement of the lymphatic system in the infectious process. The degree of their affection can essentially differ from a moderate enlargement to the development of a bubo with a diameter of 3-5 cm. The ability to detect the changes of the lymph nodes is of great importance in the differential diagnostics. This symptom is especially important now when HIV-infection is widely spreading in all the areas. At the same time the physicians quite often do not pay proper attention to the state of the lymph nodes and do not always correctly carry out the examination for the differential diagnostics.

The improvement of the infectious diseases diagnostics is closely connected with the development of microbiologic, gene-diagnostic, immunological methods of investigation. The latest methodological achievements allow not only to essentially raise the level of etiological confirmation of the diagnosis, but also to present the detailed characteristic of the microbe behavior in the organism. In particular, it is not possible to judge about the quantity of microbial bodies in different substrates of the organism, to determine the availability and concentration of antigens, toxins and even separate molecules of the. microorganism. The gene-diagnostics opens rather comprehensive possibilities, however, the biosensory (including immunosensory) methods of investigation, which are already being worked out in a number of the countries, are next in turn.

But a great number of the laboratory investigations that are available for a doctor are not always important for the diagnosis and are sometimes overestimated and distract the attention from the clinical diagnostics. The clinical examination of the patient is of a primary importance and the laboratory and instrumental methods are supplementary. Every laboratory test should be evaluated according to its specific features, sensibility and informativity, it is necessary to determine the indications and terms of the investigations in different nosologic forms and to state their comparative diagnostic value.

The treatment of infectious diseases is more complicated task in comparison with therapy of other palhologic conditions as besides the correction of the disorders in the function of the organs and systems, it has a complicated task -to eliminate and suppress the infectious agent.

In the historical aspect only from the 17th century when the improvement of the agricultural production resulted in a better nutrition, it had an immediate effect on the outcome of some infectious diseases. At the beginning of the 191h century

Introduction of infectious diseases 21

the improvement of the sanitary-hygienic control over food and water resulted in the decrease of many infectious diseases transmission. Later the knowledge of the specific etiology of the infectious diseases promoted the creation of the scientific base for their prevention and treatment. In the 20th century when the methods of immunization were widely used and especially when the antibiotics appeared the morbidity and mortality from infectious diseases were considerably reduced. The children's mortality was sharply reduced. The lifetime in the developed countries increased from 47 years on the average till 70 years.

Despite the increasing role of the microbial factor under different pathologic conditions, the practice of treating patients in polyclinics and somatic hospitals has not changed essentially. The treatment of the patients is mainly based on trial-and-error assigning the coolest or the most available antibiotic, as there are no real possibilities and the doctors striving to study the development of the infectious process in dynamics. At its best a single-pass serological or microbiologic research revealing the infectious agent is used as a sufficient argument for the statement of the clinical diagnosis and assigning the therapy. Therefore it is not surprising that there is no noticeable progress in outcomes of treatment, and there is an increase of negative consequences such as the medical disease,immunodefence disorders, development of dysbacteriosis, appearance of polyrefractory microorganisms.

Due to the technological achievements a large number of antibacterial and antiviral drugs have been made. The availability of drugs considerably dilates therapeutic capabilities, but also demands a scientifically reasonable differentiated approach.

The semi-centennial experience of the antibiotic therapy in the infectious disease treatment has not justified the initial hopes. After a considerable increase ol the treatment efficiency of bacterial infections in the 50-60s, despite the appearance of a broad spectrum of new antibiotics,the multiple increase of uptaken doses, there have been no adequate progress in the results of treatment, but the number of cases of the drugs intolerance and therapy complications have increased. The indispensable condition of the therapy efficiency is the differentiated approach to drugs in dependence on the way they act, capability to the intracellular infiltration, bacteriostatic or bactericidal influence.

Control questions:

1. The origin of infectious diseases.

2. The main features of infectious diseases.

3. The basic types of interrelations between micro- and macroorganism.

4. Human demographics and behavior.

5. Microboial adaptation and changes.

6. The rate of pulic health measures.

7. The nature of temperature curve.

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8. The exantemas in infectious diseases.

9. Another essential characteristics of infectious diseases.

8.

22 . Infectious diseases

Date: 2014-12-21; view: 1193