Rickettsial pneumonia. The lesion of lungs can develop at a number of rickettsioses, but practical value has only specific lesion of lungs at fever . In the beginning at this disease the pneumonia became perceptible so often, that fever named even a pneumorickettsiosis. Now it is established, that the lesion of lungs is observed far not in all cases of fever . Possibly, the pneumonia is characteristic for the cases of fever buy cipro 5mg resulting aerogenic infection, and at other ways of transfer (alimentary, transmissible, contact) illness proceeds without pneumonia development. The lesion of lungs at fever is specific (rickettsial). Besides the pneumonic centres, at patients tracheobronchitis signs, as a rule, become perceptible, but never there are no symptoms of a lesion of the top respiratory tracts (a rhinitis, a pharyngitis, a laryngitis). The pneumonia is not unique implication of fever . However for this disease polymorphism of clinical semiology and its diagnostics (and consequently is characteristic, and definition of rickettsial character of a pneumonia) to other clinical signs also represents the big difficulties. To think of possibility of a rickettsial pneumonia follows on the basis of set of the received clinical data. Physical implications of a rickettsial pneumonia same, as well as other pneumonia, it is possible to note only their radical character and involving in process of radical lymph nodes. The pneumonia remains is long, the involution of its semiology begins only after body temperature normalisation (the fever lasts usually to 2 ). Radiological changes remain usually during 6 . From the general implications of fever it is possible to note the acute beginning, a fast fervescence (to 39 … 40 °), a headache, pains in eyeballs, retrobulbar pains, , a sleeplessness, the raised sweating. There can be a hyperemia of the person and a neck («a hood symptom»), a vasodilatation of scleras. The liver and a lien are early enlarged. The temperature curve with the big daily allowances and unlike a curve at others varies at a prescription of antibiotics, including
Tetracyclinums a little. At a blood analysis become perceptible a leukopenia (less often ), the neutropenia, an ESR is moderately raised. Differential diagnostics is based on following data. Epidemiological preconditions (stay in districts, contact to animals, the use of crude milk), the acute beginning, a high fever, early augmentation of a liver and a lien (3 are considered... 4th day of illness), unlike a canicola fever there is no icterus and a lesion of kidneys. The long current of a pneumonia, its combination to bronchitis signs are considered also. For diagnosis acknowledgement it is more often used with a specific rickettsial antigen. Melioidosis. Pulmonary forms of a melioidosis can be observed in our country only as brought in cases at a becoming infected of the diseased in some districts of Southeast Asia (Vietnam, Laos, Kampuchea, etc.) . The lesion of lungs can acutely develop, right after infections (an incubation interval from 2 till 14 days), however more often the specific pneumonia develops after some months and even years after a becoming infected as a result of transition of the latent form of a melioidosis in the demonstrative. In these cases the lesion of lungs develops gradually. There is a general delicacy, a malaise, tussis with purulent, and sometimes and with a sputum. Delicacy accrues, the patient grows thin (loss of mass of a body reaches sometimes 10 … 15 kg). A fever more often wrong type with the big daily buy rimonabant 5mg allowances . There are pleural stethalgias. Tussis amplifies, the considerable quantity of a purulent sputum is quite often allocated. Radiological changes remind sometimes changes at a pulmonary tuberculosis. Process is more often localised in the top shares. In the beginning there are infiltrates. Then there can come their disintegration with formation of thin-walled cavities in diameter from 1 to 4 sm, is usually formed 2 … such 3 cavities, but can be and more. For differential diagnostics a pneumonia great value has the epidemiological anamnesis (stay for last years in districts), subacute disease, a lesion of mainly top shares of lungs, tussis with a considerable quantity purulent or sputums, a weight loss, a fever of wrong type, formation of thin-walled cavities in lungs, negative results of research of a sputum on a tuberculosis micobacterium.