BAKTH

GRAM

Bacillus anthracis => : , ,

() => =>
.
, ~ .
, 20%
(95% )
-- => :
, 95%

=> URI =>

=> . =>

Bacillus cereus => :
() 1-6 , , ,
, <24h
, / .
: , ,
. >24h
, , ,
() . ,
=>
=>

Corynebacterium : ,
diptheriae , , .
, ~,
=> : , =>
10% 7-14 ., : ++
=> 2-4 , , : +
2-6 .. ++
, , + 7
,

Listeria monocytogenes : ,
1-5%, (+)
, , ,
=>
=> (2-3):
( ) , .,
( )
11-70
Gardnerella vaginalis : ? gel x2x5
20-40% => . x1x7
, p.o.
: 500mg x2x7
Bacteroides, Mobiluncus p.o.
300mg x2x7

Clostridium perfringens :
() ( 8-24h) ,
, ,
,
( 1-5 )
Clostridium tetani , : , &
() & . .. , - >10: Td
=> , => - & <10:
( 3-14 ) , ,
, -: d+TIG
3-7, - & >5: d
7, - & <5:
, .,
(),
. ()
Clostridium botulinum , , : ,
() =>
1

-,
, ,
, . OXI < 6
, (10% )
: , , ,
=> . , ,
( 12-36 ) , , ,
, ., G
<,
: .,
( 4-14) , G
Clostridium difficile ,
() ,
, .
GRAM

Staphylococcus aureus 30% 1. , ,

(.) ,
2. ,

=> , 3.,
, (, ),

( ,
)
4. .
(.
)
5.
( )
6.,
.
7.,
( < 1 )
8.,
,
.
9., ..
10./

Staphylococcus , 1.
epidermidis & 2. (+ )
.
Dacron,

3. /
,


4.

Streptococcus , -, C<0.1:
pneumoniae 90 ( , - , MIC 0.1-1: /
) , -. ,
, , MIC >2:
(,
, , .) : PCV7 2-4-6-12/15
. : PCV7 2 +
P23 1 +
():
-
Streptococcus pyogenes 15-20% 1. (5-15 - , ,
(Group A Strep) ), ,
, -
, -STO, anti-DNAse-B, /.
& ..
2.
3. ,
,
(.+),

2

(<6 , )
4. ,

5. .

6.

7. (.
, ,
, )
Streptococcus agalactiae
=> ( )
(Group B Strep) ( <72) =>60%

( 2-4 )
GRAM

ENT
Escherichia coli , H A I P T -P/SMX
+ +
+ + + -/: +
+ /
: ,
157:7 15% HUS -:+
P: ..
:
1.
2. ,
,
3.
Salmonella typhi 1. : /, , , -
=> => , , , -TMP/SMX
=> ~ , - (
, , , , )
(->->), ,
=> => :
-
-,
.
-<50%

-
-()
( )
: 1-10%
/ , ,
- ,
,

-
()
-
( )
Salmonella ( 1. ( . , , -
) , , ) ~ , , -TMP/SMX
2. 2-5 - (
3. ( (~, ~) )
) 70% (38-39
6-72 2 )
<3, :
& ,
( )


Reiter
Shigella dysenteriae, 1. => 1. ,
flexneri, boydii, sonnei , TMP/SMX
, 2.,
1-7 , .
1
3., HUS,
, Reiter
3
Yersinia pestis
Yersinia enterocolitica & 1. - ., , -TMP/SMX
(), , (2-3, IBD) , .. - (
, , , 2.(Fe po => - )
=> . )
1-3 3.
4.
5. ,
Reiter,
/
Klebsiella pneumoniae
Proteus mirabilis
Enterobacter
GRAM
Vibrio cholerae / => - -
=> , ( ) LISA -TMP/SMX,
, , => -, , 3-5
, , -
6 3 => (,
, / )

Campylobacter jejuni & => , , -
=> -
()
=> 1
Helicobacter pylori
Pseudomonas aeruginosa 1.. () , , , -/ +
( ) 2. ( )
3. ( ) - +
4.
()
5.
( .
/ )
6.
(, ,
),
,
(),
()
Moraxella catarrhalis , /

Haemophilus influenzae ib - , ,
- .
(: - -latex ,
2-5%: ib) - , 2-4-6-15
<4 -
- :
-
- <4
:
-, -
, ,

- ,
,
Bordetella pertussis, =>
parapertussis 6-14 (1-2 ) ,
30% . <6 , , , DtaP
.. <1 , ,
Bordet-Gengou :
(2-4 ) Ab <7 <3
, , . <7 >3 +
, >7
, .
(1-2 )

Francisella tularensis 6 : KA , (+
() => , - >8)
, , , ,
,

4
 /, ,
3-5 :
( 2 )
=> =>

: ARDS,
DIC,
Brucella , , - (), 6 :
melitensis (), (, ) - +
abortus (), => -Wright (+ 3-4 ) (<8 )
suis (), canis => .. - +
, (), (>8 )
1- () (30%)
~, ~5-10%

,

( )
,
Legionella pneumophila
Bartonella henselae 90%
. /SMX
3-10 =>
2 =>
(30% , )
=> 1-4
: ,
Calymmatobacterium :
granulomatis => TMP/SMX
8-80
ANAE
Bacteroides fragilis

GRAM

Neisseria meningitidis 2-5% => => , ,

=> 80% => .
<10 , .
( 3-4 ) => ., DIC, PCR ,
, W135, C(1/3), Y(1/3), , . >2
[ ] , ..
B(1/3) . .
&C .

Neisseria gonorrhoeae (, , po 400 mg x1 +
.. po 100mg
3-14 & .) x2x7
- => ... .
(): 2.5% => iv 2gr x4 +
iv 100mg
- x2
(): 13% po
100mg x2 . 14

Treponema pallidum : (<1 ):

pallidum => : . G im
, : VDRL, RPR 1.000.000 IU x 1
=> 10-90 => 2: :FTA-ABS, MHA- po 100 mg x
. TP 2 x 1-3

=> 4: : (>1 ):
, . G im
, . 1.000.000 IU
, 3
po 100 mg x
(. &) 2 x 4
=> 2-10
=>
:

5
 (15%),
(10%)(8%)
: 100.000-150.000 U/kg/d
: T.pallidum 2 7
, , , , 3
2 , . 3
(<2): :
2/3 (&), 90
, ,
., ,
, , :
, - .
(>2 ): -:VDRL+,WBC,P
, -
Hutchinson -
( , -FTA-ABS-19S IgM+
, -4
),

Borrelia burgdorferi => Lyme: 2-3 :
=> 3-32 1 : ELISA Western 1 :
blotting
& 2-3 :
=>
=> . G
(. )
~, ~
+ , , :
, , OspA,
=> ,
2 (5):
, ,
.ST, .(10%)
,
,
,
,
(.3)
3 (-):
=> 10%
, , ,

Leptospira interrogans ,, 2
.=>=> 1 (3-7 )
, , , , [ 1-
(. 6) 2 , 3 ,
=> 2 (10-30 ) ]
.
=> 1-2 ,
, ,
, &
(.Weil)

Rickettsia rickettsii , => -

3-5 => 2
1-8 , , ( 7-10 )
=> ,
(, )

(1/3)
: , ,
, DIC

: 10-40%
Rickettsia prowazekii => -

Rickettsia typhi , => -
,
8
Ehrlichia phagocytophilia , -
(, ),

6
 equi (), canis ( ) , ,
(, ), : , , .
, DIC

(, : 2-3%
) =>
=>
5-10
Coxiella burnetii , , Q -
=>
18-20

Chlamydia trachomatis 5-12 40% . po 100mg

, x2x7
. . ELISA, DNA po 1gr
(): .. (DNA probes), PCR, x1x1
=> ... LCR .
=> iv 2gr x4 +
(, iv 100mg
(): 60% .. x2
& .) po
100mg x2 . 14
20-30% / , p.o.
. .
3-10 , , ~ (400)
, ,
, .
(50% + )
: p.o.
~2 , , . . . .
.

=>
=>


Chlamydia psittaci
Chlamydia pneumoniae -6-10%


-
.

Mycoplasma pneumoniae 6-15 - , 65%

-, (IgM
-, I
2-3 - . 4C)

Mycoplasma hominis , .



Ureaplasma urealyticum

Mycobacterium
tuberculosis
Mycobacteria kansasii, , , , ,
scrofulaceum, avium- =>
intracellulare , =>
marinum, fortuitum- (, , =>
chelonei )

IOI
DNA
(ds linear DNA, brick shaped, enveloped)

7
 (ds linear DNA, icosahedral, enveloped)
1 (, -. -
) (1-3 , , ( Tzanck)
2-12 , , -
7-14 ) - Ag
- -PCR DNA => .
- ( -
, ,
. )
-
- (
,
75% )
-
-
2 , -
2-12 (, , ,
, ,
10-20 )
- ..
(50-80% )
- (50%
, 50% )
& -: - VZIG 4
=> ., (, , ( Tzanck) :
=> ) => , - 1. 5
& URI => , - Ag 2
=> => 3-4 ,
=> 2.
, 3. <28
90% 10 , 4. >28
11-20 : ,
, , 5. .
, , 6.
<10 : , , 7.
-, , , 8.HIV
& , , Reye,
, , Guillain-
, Barre,
, ,
-:, .
-:,

(.Ramsay Hunt) <20 =>2%
-: : . . &
& . ,

pstein-Barr () - -,
( (20-40%),
) -: , .
3 , . - (IgM
30-50 , , ): Paul
, , Bunnell, Monotest (>5)
, , - :
Reye, , VCA IgM, EA Igs
Guillain-Barre, - :
, VCA IgG, EBNA Igs
.
-:
Burkitt
,
, ,
...
, , : - ,
, -() - ,
, , , -. -PCR DNA
-
- -
V: ,
, ,
.
.-:
8
 ,
- 10% : ,
: 2-2.5% -50% // , ..
( -50% :
: , : 3
, : , , -
-
) , -PCR DNA
- : -80%
=1% /, - gM
=40%
90% :
<15%
6 - (6
2 ):
- (40+) 3-7 ,
,
, .,
, .
=> =>

7
(ds linear DNA, icosahedral, NOT envel)
51 -. . -
(., ) -PCR
. - (,
, , , WBC,
.)
2-14 - (
)
-
-
-
(. & )
HEPADNA- (ds/ss circular DNA, spherical, enveloped)
1-3
(ds circular DNA, icosahedral, NOT envel)
(.1-5,8,10,
=> 17,20,36)
, ,
, (6, 11)
(6,
11)
,
(16, 18)
JC &
=>
=> 40% .
,
,
( 15)
BK &
=>
=> 40% .
,
,
( 15)
(ss linear DNA, icosahedral, NOT envel)
19 & (5 , -
): , ,
, => 7-
40-60% 10 => , - IgM
: ., -PCR DNA
- . / =>
// 1-4 => ,
11(2-40),
-
- (: ,
, ,
)
RNA

9

& => )cough,coryza,conjunct, - - <5
=> ,Koplik,Stimson(3) .
=> )24, , -
=> >> -
> (5)
( 9-12) ) , , 15 & 4-5
- - () 11-12
( )
- - .
(3-10 ,
, )
-...
- :
,
, , , , 15 & 4-5
=> => , , 11-12
=>
=> (3-7),
=>
=> -10%
( 12-25) ( , >10
- 1 )
3 -15-35% ,
-1/3 ,
=> ( )
-
-: ,


.
- & , / , -
, ,
2 -PCR RNA -RSV
-, , -
ELISA
( 5-8) : -
+
- 1-3 -
, 3 -
-
- 4 () ELISA
-, , ( 5 )
: ,
( 2-4) Guillain-Barre, Reye, - PCR RNA

: : - (25%), po
: 3-4 -, (10%) inh
C , , , ,
, , - ()
, -
(50%), - :
, ELISA ,
=> , , ,
(10-40 ) - 2-5 , ,
& 4-10 ,
=> : ,
-, ,,
( 1-3) , URI
- ,
:
-:,
, Reye,
- URI

10

-
-HRIG (1/2 )
- (0,3,7,14.28)

Marburg
Ebola

-

& (<18): -.:
, , : - & PCR , ,
, : DNA 0 , ,
, (2: , , (), 1 , 2
(2/3 , -..:
) URI, ) 12 ()
: -.:
(1: +) : , ,
( 25%), C: -..
( (RNA>104/ml) -: P/SMX
=> 8% AIDS -. (Pn.carinii),
..) (M.avium-intracellulare),
gp120 + CD4 => 1: -
- (1500:1:1000:5:500) (..)
=> 2: -:
(750:500:200) (VZIG), (-)
3: -: VZV,
(< . ) CMV, EBV, ,
7-10 .: , ,
: 1-24 .. ,
( 5 !) VZV, MAC, PCP,CMV Pn.carinii
&,
: 80% wasting, ,
PCP: , ,
, 20% , , /
1 . => BAL

: polio1-3, cox 1- - (95%) -

24 ( 23), 1-6 - -
echo 1-33( 10, 28) - -DNA probes
() -, , ( RNA
=> . => , )

11
 Coxsackie, => => , - (50%)
Echo, , , , -
70-71 => => -
(, ,
, )
3-6 -
24,70-

16- -
-
1-5 ,

- (,
, .)
-,
ECHO11-

-. ..
-
( ,
&
)
-

=> -, -1 90%
=> =>
=> => -. ( )
,
( 14-21) , 3 -
- 2 7 -, - :
, , , ,
-2/3
- &
,

Norwalk

Entamoeba histolytica () => 1. - :
, 2. (+, -
, => ), ., -: US/CT (
=> )
(, , ( ) . :
, ) 3. , ( )

: ,

Giardia lamblia , , 1. - , 12
() => 2. , , nterotest
/ , -g (ELISA) DNA
=> 3. , (PCR)
(12) , .,
()
-Dientamoeba fragilis
-Balantidium coli
-Isospora belli
Cryptosporidium ( & ) - . -
=> , . 2 -
2-14 -:


12

Trichomonas vaginalis 2gr po
Ag
( ), (
, )

&
Plasmodium vivax, () : ( : 1
ovale, falciparum, => => , , /12) 4 1/
malariae (8-25) , , - :
=> => , => -:
- (vo)
=> & - (f) :
=> - :
+ ( vo)
6-16 -: +
- (m) + /
-Babesia
Toxoplasma gondii ( - - (Daraprim)
), - - po 1mg/kgx2x3 =>
( ) => - 0.5mg/kgx2x28
- KAI
(Adiazine
-: po 25-50mg/kgx4x28
KAI
(Leucovorin)
- 1-2/1000 1. -IgM (Daraprim)
2. -
- : 70% => (Adiazine
, , KAI
MR, . (Leucovorin)
- 3., , 12
=> 50% ,
, (Prezolon)
, .
,

Leishmania , => 20% <=
donovani () => 60% (, (Glucantime)
(, ) => 20% 20-30
=> (-), & )
<5 ,
( ) ,
3-7 , ~,
,

: ,
, ,

Leishmania , => => - 1
tropica () => => -
mexicana () (Glucantime)
braziliensis (- 20
) -

Trypanosoma cruzi , => Chagas (Lampit)
=> => - , PCR
( 1-2 )
-
( Romana)
-, ,
, ,
,
~
~50%
Pneumocystis carinii

Enterobius vermicularis (, : - (Vermox)

, .) => po 100mg x1 &

13
 => 2
: , -
=> (Zentel)
=>
=>
& (Combatrin)
(.2)
Ascaris lumbricoides ( ) : - (Vermox)
=> => , po 100mg x2x3
=> , , ,
/ (Zentel)
=> => : . &
=> =>
: , (Combatrin)
, .
Ancylostoma duodenale, (, : , - (Vermox)
Necator americanus ) => => , po 100mg x2x3
=> => . , ,
=> , , (Zentel)
=> , .

(Combatrin)
Toxocara canis, catii, ( , , ,
leonina , ) => => . , ,
, , ELISA 4
=> => :
=> , ,
=> , , . , (Vermox)
, , . po 200mg x2x5
=> , .

-Trichuris trichiura (Vermox)
po 100mg x2x3

(Zentel)

Schistosoma () 3-12 => &

haematobium() => , , (Biltricide) po 20mg/kg
mansoni() => => , ., x2x1 x3x1
japonicum()
mekongi() . haemotobium ():
intercalatum() => (, ) , Ca
=> mek,interc ():
=> , ,
. , ..
( ):
, , /
,

Taenia solium () - => CT - 2-3

( ) => . : ,
=> () , . ( )
() => , - (. - 1
=> ( ) => ) => - ,
=> (,
=> , ,
. ,
.
-Diphyllobothrium latum
Echinococcus granulosus (. : , -
, ) => , , (
=> () : .. NaCl)
=> => : &

=> & => -

MYKHTE

Malassezia furfur
Exophiala werneckii

14
Piedraia hortae
Trichosporon beigelii

Histoplasma capsulatum
Blastomyces dermatitidis
Paracocciodes
brasiliensis
Coccidioides immitis
Cryptococcus
neoformans
EYKAI
Candida albicans
Aspergillus fumigatus
Rhizopus, Absidia,
Mucor

15