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导言下呼吸道感染包括支气管炎、肺炎、肺脓肿、胸膜炎及脓胸,可以由许多不同的微生物所引起,例如病毒、立克次体、细菌、真菌和寄生虫。尽管不同的微生物可能引起相似的疾病类型,但是基于临床迹象的不同因素,至少可帮助医生们做出印象诊断。鉴别诊断上的重要考虑因素有病人的年龄和一般健康状况,病人暴露于感染的环境,呼吸道症状的发生和过程,非呼吸道症状的呈现和类型,以及理学检查所见。必要时还应照胸片、白细胞计数和微生物学检查。当医生已达到工作的诊断阶段,可做出合乎逻辑的治疗方案;如果,实验室检查和疾病过程提示一个不同的诊断,则可以修改此计划。本文综述了下呼吸道感染的许多病原和临床类型,并根据上述的因素提出处理依据。
Introduction Lower respiratory tract infections, including bronchitis, pneumonia, lung abscess, pleurisy and empyema, can be caused by many different microorganisms such as viruses, rickettsia, bacteria, fungi and parasites. Although different microbes may cause similar types of disease, at least the doctors can make an impression diagnosis based on different factors of clinical signs. Important considerations in differential diagnosis are the patient’s age and general health status, the patient’s exposure to the infection’s environment, the occurrence and course of respiratory symptoms, the presentation and type of non-respiratory symptoms, and the physical examination. If necessary, also according to the chest, white blood cell count and microbiological examination. When the doctor has reached the diagnostic phase of the job, a logical treatment plan can be made; the plan can be modified if laboratory tests and disease processes suggest a different diagnosis. This article summarizes many pathogenic and clinical types of lower respiratory tract infections and suggests treatment based on the above factors.