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3,
7
],
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"lead": "токсикоинфекции вызываются чаще всего бактериями паратифозной группы (сальмонеллами), заболевание связано с явлениями кратковременной инфекции и последующей интоксикации.",
"description": "",
"etiology": "<p>Инкубационный период при токсикоинфекциях колеблется от нескольких часов до 1—2 сут. После этого периода появляются <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">тошнота</a>, <a href=\"/symptom/rvota/\" title=\"Перейти на страницу симптома Рвота\">рвота</a>, боли в области живота, <a href=\"/symptom/diareya/\" title=\"Перейти на страницу симптома Диарея\">понос</a>, повышается температура.<br /> Основной источник инфекции — мясо больного животного или животного-бациллоносителя. Инфицирование продуктов может происходить и в процессе обработки и хранения, при нарушении во время разделки туши целости кишечника животных-бациллоносителей, контакте с тарой, предметами оборудования, обсемененными возбудителями токсикоинфекций.</p>\r\n<p>Для возникновения токсикоинфекции имеет значение не только факт инфицирования продукта, но и степень обсеменения его. Причиной токсикоинфекции могут быть и другие продукты и блюда — винегреты, салаты, пирожные и т. д. Однако и в этом случае первоисточниками инфекции, как правило, являются животные продукты (мясо, молоко, яйца), входящие в состав блюд или находившиеся с ними в контакте через посуду, оборудование.</p>",
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"prevention": "<p>Первое, на что нужно обратить внимание — это цвет, вкус и запах пищи. Заражённые продукты пахнут, естественно, неприятно, имеют кисловатый вкус.</p>\r\n<p>Также один из признаков испорченности продукта — это газовые пузырьки, плесень. При открывании консервы следует обратить внимание на хлопок крышки, который обязательно должен присутствовать. Если его не было, то необходимо задуматься о свежести продукта.</p>",
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},
{
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{
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{
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},
{
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},
{
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},
{
"name": "боль в мышцах рук"
},
{
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},
{
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},
{
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{
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}
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"code": "A04",
"name": "Бактериальные кишечные инфекции",
"icd_name": "Другие бактериальные кишечные инфекции",
"gender": 0,
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"cause": [
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"slug": "a04_bakterialnye_kishechnye_infekcii",
"lead": "к бактериальным инфекциям относится огромная группа заболеваний, причиной которых являются микроорганизмы – бактерии. Это небольшие одноклеточные микроорганизмы",
"description": "",
"etiology": "<p>Обычно заражение происходит при употреблении: сырой воды или молока; тех продуктов, которые не могут быть термически обработанными (торты с кремом, кисломолочные продукты); необработанного термически мясо; птичьих яиц, выпитых сырыми или неполностью проваренных/прожаренных; пользования общими полотенцами, посудой, контакт с сиденьями унитаза, дверными ручками, игрушками в том доме, где живет или работает больной, после чего здоровый ранее человек не помыл руки; купание с заглатыванием воды в открытых водоемах.</p>\r\n<p>Учитывая, что бактерии очень большая группа микроорганизмов, они разделены на несколько групп по определенным критериям.</p>\r\n<full></full>\r\n<p>По способу питания:</p>\r\n<ul>\r\n<li>сапрофиты – свободно живущие бактерии, которые питаются не живыми органическими веществами, не болезнетворные (единственным исключением являются легионеллы – микробы, обитающие в жидкости кондиционеров, при попадании в организм человека вызывают пневмонию);</li>\r\n<li>паразиты – питаются за счет других, в эту группу относятся все болезнетворные бактерии, а также необходимые микроорганизмы, которые живут в «содружестве» с человеком (нормальная микрофлора кишечника состоит из полезных бактерий, которые в процессе жизнедеятельности синтезируют витамины группы В, необходимые организму человека).</li>\r\n</ul>\r\n<p>По форме клетки:</p>\r\n<ul>\r\n<li>кокки – шаровидные бактерии. К ним относятся: менингококк (менингит), стафилококк (большинство гнойничковых заболеваний), пневмококк (пневмония), стрептококк (ангина, , стрептодермии).</li>\r\n<li>палочковидные бактерии – форма клетки в виде прямой или изогнутой палочки. Возбудителями заболеваний являются: кишечная палочка (острые кишечные инфекции, воспалительные заболевания внутренних органов), шигелла (дизентерия), микобактерия туберкулеза, дифтерийная палочка (дифтерия), возбудитель столбняка.</li>\r\n<li>извитые бактерии – по форме напоминают спираль штопора: бледная трепонема – возбудитель сифилиса, лептоспиры – заболевание лептоспироз (интересно, что форма штопора помогает спирохетам буквально «вбуравливаться» через кожу человека и таким способом проникать в организм).</li>\r\n<li>бактерии, меняющие форму – особая группа бактерий без клеточной стенки, являются внутриклеточными паразитами: микоплазмы (хронические заболевания мочеполовых органов, трудно поддающихся лечению).</li>\r\n<li>жгутиковые формы – бактерии на клетке имеют жгутики, активно двигаются во внешней среде, что позволяет им увеличивать возможность заражения (холерный вибрион – возбудитель холеры).</li>\r\n</ul>",
"pathogenesis": "<p>Самым важным в развитии заболеваний, вызванных бактериальной инфекцией является выделение бактериями токсинов (ядов), которые обладают воспалительным действием, вызывают интоксикацию организма и повреждают внутренние органы:</p>\r\n<ul>\r\n<li>эндотоксины – выделятся после гибели бактерии и разрушения ее клетки (кишечные инфекции). Наиболее опасным является эндотоксин менингококка при менингококковой инфекции. В случае гибели значительного количества бактерий, выделившийся эндотоксин может привести к развитию инфекционно-токсического шока и привести к смерти.</li>\r\n<li>экзотоксины – яды, выделяемые живыми бактериями в процессе их жизнедеятельности (дифтерия).</li>\r\n</ul>",
"diagnostics": "<p>Основным методом в диагностики бактериальных инфекций является бактериологическое исследование. При этом от больного берется материал, содержащий бактерии, и засевается на специальные питательные среды. После роста колоний на питательных средах (около 48 часов), бактерии идентифицируют. Огромным плюсом данного метода является возможность проводить исследование чувствительности выделенной бактерии к антибиотикам, для назначения рационального лечения. Также используются:</p>\r\n<ul>\r\n<li>микроскопическое исследование материала – позволяет поставить ориентировочный диагноз при выявлении бактерий с помощью микроскопа.</li>\r\n<li>серологическое исследование – определяется наличие антител в крови к определенным бактериям, увеличение титра антител свидетельствует о наличии в организме бактерий.</li>\r\n</ul>",
"treatment": "<p>Лечение бактериальных инфекций, как и любого другого заболевания, является комплексным и включает:</p>\r\n<ul>\r\n<li>этиотропная терапия – лечение, направленное на уничтожение причины заболевания – бактерии. Для этого используется арсенал антибиотиков. На данный момент есть несколько групп антибиотиков, но самым важным является их разделение на бактерицидные антибиотики (убивают бактерии) и бактериостатические (подавляют рост и размножение бактериальных клеток). Это очень важно знать, особенно в случае менингококковой инфекции назначение бактерицидных антибиотиков приведет к массовой гибели менингококков и выходу эндотоксинов в кровь.</li>\r\n<li>патогенетическая терапия – направлена на выведение из организма бактериальных токсинов, которые накапливаются в процессе инфекционного заболевания (дезинтоксикация). Также проводится лечение, направленное на восстановление поврежденных органов.</li>\r\n<li>симптоматическая терапия – необходима для облегчения состояния человека при бактериальной инфекции и снижения выраженности симптомов.</li>\r\n</ul>\r\n<p>В нынешнее время, благодаря антибиотикам удается излечивать большинство бактериальных инфекций, однако стоит помнить, что неправильный прием антибиотиков может привести к развитию у бактерий резистентности (нечувствительности) и даже зависимости от антибиотиков.</p>",
"prevention": "<p>Специфической профилактики (то есть вакцин или анатоксинов) ни для одной из этих инфекций нет.</p>\r\n<p>Применяются только неспецифические профилактические мероприятия:</p>\r\n<ol>\r\n<li>соблюдение индивидуальных гигиенических мероприятий;</li>\r\n<li>кипячение воды и молока перед употреблением; мытье рук после туалета;</li>\r\n<li>отказ от употребления сырых яиц (даже собранных от собственных же птиц);</li>\r\n<li>достаточная термическая обработка мяса;</li>\r\n<li>скрупулезный просмотр сроков годности тех продуктов, которые вы собираетесь покупать;</li>\r\n<li>мытье овощей, ягод, зелени, фруктов перед употреблением;</li>\r\n<li>хранение готовой продукции в холодильнике;</li>\r\n<li>отказ от кормления грудничков неразведенным коровьим или козьим молоком;</li>\r\n<li>поддержка достаточных санитарных условий в доме/квартире;</li>\r\n<li>если в семье кто-то заболел – кипячение всей его посуды, отказ от употребления еды из одной посуды, обеззараживание испражнений хлорсодержащими препаратами.</li>\r\n</ol>",
"clinical_picture": "<p>Инкубационный период – 6-48 часов. Чем раньше у взрослых появляются какие-либо симптомы с момента употребления инфицированной пищи, тем тяжелее будет протекать кишечная инфекция. Затем развиваются такие синдромы:</p>\r\n<p>Интоксикационный, который проявляется такими симптомами: ; \"></a>; в теле; \"></a>; \"></a>.</p>\r\n<p>Повышается температура тела до разных цифр.</p>\r\n<p>Гастритический синдром: ; \"></a>; после приема пищи или воды – \">Рвота</a>\">\">рвота</a></a>, после нее становится легче.</p>\r\n<p>Энтеритный синдром: тошноты и рвоты почти нет, только в самом начале, но появляется частый жидкий стул.</p>\r\n<p>Колитический синдром: боли внизу живота, болезненные позывы на дефекацию, при этом сам поход «по-большому» – тоже болезнен. Стул скудный, со слизью и кровью. После дефекации легче в животе не становится.</p>\r\n<p>Сочетание трех вышеуказанных симптомов в различных комбинациях. Для каждой из инфекций характерно свое сочетание этих симптомов, но оно не обязательно наблюдается каждый раз. </p>",
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"code": "A28",
"name": "Бактериальные зооноз неуточненный",
"icd_name": "Другие бактериальные зоонозы, не классифицированные в других рубриках",
"gender": 0,
"age_min": 0,
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7
],
"periodicity": 1,
"slug": "a28_bakterialnye_zoonoz_neutochnennyy",
"lead": "Псевдотуберкулёз — зоофильный сапроноз с фекально- оральным механизмом передачи возбудителя.",
"description": "Характеризуется полиморфизмом клинических проявлений, интоксикацией, лихорадкой, поражением желудочно-кишечного тракта, печени, кожи, суставов и других органов.",
"etiology": "<p>Yersinia pseudotuberculosis— грамотрицательная палочковидная бактерия с перитрихиальными жгутиками, относится к семейству Enterobacteriaceae. Капсул не содержит. Спор не образует.</p>",
"pathogenesis": "<p>Люди при контакте с грызунами заражаются крайне редко. Человек не может быть источником инфекции.</p>\r\n<p>Главный механизм передачи — фекально-оральный. Пути — пищевой и водный.</p>\r\n<p>Основные факторы передачи Y. pseudotuberculosis — овощи и зелень, употребляемые без термической обработки, соления (квашеная капуста, солёные огурцы, помидоры), реже — фрукты, молочные продукты и вода. Возможно заражение воздушно-пылевым путём через пыль, контаминированную вирулентными штаммами (сухая уборка помещений, подметание).</p>\r\n<p>Внедрение Y. pseudotuberculosis начинается сразу в ротовой полости, что клинически проявляется синдромом тонзиллита. Значительная часть возбудителя, преодолев желудочный барьер, колонизирует эпителий преимущественно лимфоидных образований подвздошной и слепой кишки (первая фаза). Затем происходит инвазия эпителия слизистых оболочек кишечника; возбудитель проникает в слизистый слой и преодолевает эпителий кровеносных сосудов — развиваются первичная бактериемия и гематогенная диссеминация (вторая фаза). Далее наблюдают генерализацию инфекции, характеризующуюся диссеминацией возбудителя в органах и тканях, размножение в них и развитие системных нарушений (третья фаза).</p>",
"diagnostics": "<p>Сложна при спорадической заболеваемости и становится сравнительно простой при вспышечной. Основывается на характерной клинической симптоматике и лабораторной диагностике.</p>\r\n<p>В гемограмме обнаруживают нейтрофильный лейкоцитоз, моноцитоз, эозинофилию, относительную лимфопению и увеличение СОЭ. В биохимическом анализе крови повышение активности ферментов, реже — гипербилирубинемия.</p>\r\n<p>Специфическая лабораторная диагностика псевдотуберкулёза такая же, как и при иерсиниозе. Перспективными методами специфической диагностики выступают иммуноферментная тест-система на основе белка порина.</p>",
"treatment": "<p>Рекомендуют повторное внутривенное или внутримышечное введение нормального человеческого иммуноглобулина с промежутком 2–3 дня, курс 5–6 введений.</p>\r\n<p>Если развиваются симптомы острого живота при абдоминальной форме проводят аппендэктомию. Выбор физиотерапевтических и санаторно-курортных методов лечебно-реабилитационных мероприятий зависит от формы псевдотуберкулёза и основного синдрома.</p>",
"prevention": "<p>Специфической профилактики у людей не разработано; неспецифическая включает контроль за продуктами питания, предусмотренный соответствующими нормативными документами, и санитарно-просветительную работу среди населения, особенно в группах риска.</p>",
"clinical_picture": "<p>Инкубационный период продолжается от 3 до 19 дней (в среднем 5–10 дней), иногда сокращается до 1–3 сут.</p>\r\n<p>Выделяют следующие периоды заболевания: инкубационный, начальный, разгара, реконвалесценции или ремиссии.</p>\r\n<p>Начальный период длится от 6–8 ч до 2–5 дней. Клинические проявления начального периода у всех форм псевдотуберкулёза сходны: выраженная интоксикация и полиморфизм симптомов. Своеобразие каждой формы выявляют только в период разгара. У большинства больных заболевание начинается остро, иногда бурно. Общее самочувствие резко ухудшается. Температура тела быстро повышается до 38–40 °С, может быть с ознобом. Беспокоят сильная <a href=\"/symptom/golovnaya_bol/\" title=\"Перейти на страницу симптома <a href=\"/symptom/migren/\" title=\"Перейти на страницу симптома Мигрень\">Головная боль</a>\"><a href=\"/symptom/migren/\" title=\"Перейти на страницу симптома Мигрень\">головная боль</a></a>, <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома <a href=\"/symptom/narushenie_koordinacii/\" title=\"Перейти на страницу симптома Нарушение координации\">Головокружение</a>\"><a href=\"/symptom/narushenie_koordinacii/\" title=\"Перейти на страницу симптома Нарушение координации\">головокружение</a></a>, резкая <a href=\"/symptom/slabost/\" title=\"Перейти на страницу симптома Слабость\">слабость</a>, <a href=\"/symptom/bessonnica/\" title=\"Перейти на страницу симптома Бессонница\">бессонница</a>, артралгия, <a href=\"/symptom/bol_v_myshcah/\" title=\"Перейти на страницу симптома Боль в мышцах\">миалгия</a>, боли в пояснице, <a href=\"/symptom/potlivost/\" title=\"Перейти на страницу симптома <a href=\"/symptom/potlivost/\" title=\"Перейти на страницу симптома Потливость\">потливость</a>\"><a href=\"/symptom/potlivost/\" title=\"Перейти на страницу симптома Потливость\">потливость</a></a>, <a href=\"/symptom/apatiya/\" title=\"Перейти на страницу симптома Апатия\">апатия</a>, <a href=\"/symptom/anoreksiya/\" title=\"Перейти на страницу симптома Анорексия\">анорексия</a>, иногда обмороки. Больные раздражительны, адинамичны. Нередко появляются признаки острого катара верхних дыхательных путей, жжение на ладонях и подошвах. При осмотре обнаруживают симптомы «капюшона» , «перчаток» , «носков» и инъекцию сосудов склер. Слизистая оболочка ротоглотки гиперемирована, у некоторых больных — «пылающий» зев, энантема на мягком нёбе, катаральный тонзиллит. Язык с 3–5-х суток болезни становится «малиновым». У некоторых больных — <a href=\"/symptom/bol_v_zhivote/\" title=\"Перейти на страницу симптома Боль в животе\">боли в животе</a>, <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">Тошнота</a>\"><a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">тошнота</a></a>, <a href=\"/symptom/rvota/\" title=\"Перейти на страницу симптома <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">Тошнота</a>\">Рвота</a>\"><a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">Тошнота</a>\">рвота</a></a> и жидкий стул.</p>\r\n<p>Период разгара составляет 3–10 дней (максимально — месяц) и характеризуется выраженностью симптомов конкретной клинической формы и интоксикации.</p>\r\n<p>Смешанная форма характеризуется сыпью, появляющейся у большинства больных на 2–7-й дни болезни. Чаще <a href=\"/symptom/syp/\" title=\"Перейти на страницу симптома Сыпь\">сыпь</a> скарлатиноподобная, но может быть полиморфной, эфемерной, петехиальной, мелко- и крупнопятнистой, уртикарной, эритематозной, везикулярной и в виде узловатой эритемы, иногда <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зудит</a>.</p>\r\n<p>О начале периода реконвалесценции свидетельствуют улучшение самочувствия больных, постепенная нормализация температуры, восстановление аппетита, исчезновение сыпи, болей в животе и суставах. Нередко сохраняется <a href=\"/symptom/povyshennaya_temperatura_37-38/\" title=\"Перейти на страницу симптома Повышенная температура 37-38°\">субфебрильная температура</a>. На 2–3-й неделе периода реконвалесценции появляются вегетативные расстройства, которые усиливаются при затяжном течении и формировании вторично-очаговых форм.</p>\r\n<p>При всех клинических формах заболевания обострения и рецидивы чаще возникают у больных, не получавших антибактериальной терапии.</p>\r\n<p>Септический вариант смешанной формы псевдотуберкулёза встречается редко. Летальность достигает 30–40%</p>\r\n<p> </p>",
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"code": "A48",
"name": "Другие бактериальные болезни, не классифицированные в других рубриках",
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"id": 14,
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"name": "инфекционные болезни",
"code": "B14",
"branch_medicine_code": "014",
"slug": "infekcionnye_bolezni",
"lead": "Область медицины, включающая в себя лечение 518 заболеваний. В 499 клиниках России оказывается помощь по этому направлению медицины.",
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{
"id": 23,
"disease_count": null,
"name": "неврология",
"code": "B23",
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{
"id": 16,
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"lead": "Область медицины, включающая в себя лечение 2214 заболеваний. В 886 клиниках России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 28,
"disease_count": null,
"name": "оториноларингология",
"code": "B28",
"branch_medicine_code": "028",
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"lead": "Область медицины, включающая в себя лечение 685 заболеваний. В 631 клинике России оказывается помощь по этому направлению медицины.",
"image": null
},
{
"id": 3,
"disease_count": null,
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},
{
"id": 29,
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],
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