A 35 years old patient was hospitalized by an ambulance to the infectious hospital
CLINICAL TASK № 2
A 35 years old patient was hospitalized by an ambulance to the infectious hospital. Complaints: severe weakness, increase of body temperature, nausea, vomiting, pain in a left iliac area, tenesmus, diarrhea, stool up to 15 times per day, feces with mucus. Anamnesis of illness: he became ill acutely 2 days ago, when at first a stomachache
round a belly-button appeared. In 2 hours diarrhea began. Stool was up to 4 times per day by liquid feces without admixtures. The temperature of the body rose to 38.0°С, there was non-permanent vomiting. On the second day the state of the patient worsened: the signs of intoxication grew, the body temperature did not diminish, attacks of stomach aches increased and were displaced in a left iliac area. Stool was up to 15 times per day with mucus.
Epidemiology anamnesis: the day prior to the disease a patient drank milk, ate a cake with a cream and boiled eggs.
Objective status: The general state is of middle severity, T is 38,2°C, HR is 94 beats per minute, RR is 20 respirations per minute, BP is 120/80 mm Hg. Consciousness is clear. The patient is flaccid. Skin is of ordinary color, dry, the turgor is normal. Any rash is absent. The tongue is coated by white-brown cover, dry. Heart sounds are muffled, the rhythm is correct. Pulse is satisfactory. On auscultation there is vesicular breathing. Any wheezes are absent. The abdomen is soft, painful to palpation in the left iliac area. The sigmoid is spasmodic, palpable like a dense rope. The signs of peritonitis are absent. The liver and spleen are not enlarged. Feces are liquid with mucus and blood. Total amount of urine per day is normal.
QUESTIONS:
1. Make and explain the diagnosis?
2. What immunological researches must be applied for diagnostics?
3. Name the methods of diagnostics of disease.
4. Name the terms of discharge from hospital for the patients of decreed and non-de creed groups.
5. Appoint the treatment to the patient.
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