Leptospiral immunoglobulin (after a preliminary desensitization) is prescribed if the clinical course is severe: during the 1
day 10.0 ml, during the2-3
days of the treatment – by 5.0 ml intramuscularly.Pathogenetic therapy is emphasized in case of a severe clinical course of leptospirosis, especially – if there is acute renal failure and DIC-syndrome.Parenteral introduction of isotonic solutions of glucose (5% solution – 500.0 ml)and sodium chloride (0.9% solution – 500.0 ml) with ascorbic acid, calcium preparations,
aminocapronic acid is used; in case of intense muscle pains – analgesics. Treatment of ARF is expounded in section “HFRS”.
is necessary by clinical indications.
of contact people is not carried out.
– is performed after clinical recovery. After the discharge therecovered people are subject to regular medical check-up during 6 months:depending on a lesion of a system during an acute period later on supervision of nephrologist, neurologist, ophthalmologist is required.
CONDUCTION OF THE LESSON
The aim is – to learn how to diagnose leptospirosis according to clinicaldata, epidemiological anamnesis, laboratory examination, as well as to plan thetreatment.
Control questions at the beginning of the lesson:
Where the disease is common?
Name the source of the infection in case of leptospirosis
Is a man a source of the infection in case of leptospirosis?
Channels of leptospirosis
What happens in kidneys, liver and vessels in case of leptospirosis?
Name clinical signs, which are typical of leptospirosis
Which symptoms indicate a severe clinical course of leptospirosis?
Name complications of leptospirosis
Name laboratory methods of confirmation of the diagnosis
Name groups of preparations for treatment of leptospirosisTo discuss the theme of the lesson a student manages a patient, makes a brief report about the patient’s history (in the absence of the patient withleptospirosis in the department). It is necessary to find out the following dataabout the patient:Surname, name, patronymic name; age, place of work and residence (city,village), date of the falling ill;