INTFECTIA URLIANA

INTFECTIA URLIANA

I.DIAGNOSTIC PARACLINIC

1.INVESTIGATII NESPECIFICE

-hemoleucograma, VSH, CRP, Fibrinogen,

-amilaza serica, amilaza urinara, uree, glicemie, TGP,

-sumar urina

*In determinare meningiana - punctie lombara - LCR - clar, opalin, limf.↑ (90 %), leucocite-300-2000/mm3

- alb.usor ↑, cl = N, gl = N, bacterioscopic negative

-EKG (in determinare miocardica)

-Ecografie abdomino-pelvina (in determinare pancreatica, orhita)

II.DIAGNOSTIC ETIOLOGIC

-serologic-evidentiere IgM antivirus urlian-RFC,Reactie de neutralizare,RIH

-evidentiere Ac anti virus urlian din LCR-ELISA

II.TRATAMENT

1.Igieno - dietetic - spitalizare in complicatii,determineri extrasalivare

- repaus la pat

- regim alimentar fara dulciuri,fara grasimi,hiposodat in caz de corticoterapie

- caldura umeda regiunea parotidiana tumefiata

Parotidita, submaxilita

2.Simptomatic - analgezice, antitermice, antiemetice, sedative, fermenti pancreatici, vitamine (multivitamine), vitamina C

3.Patogenic - AINS- ibubrufen, ketoprofen, diclofenac; anitacide - dicarbocalm, malucol;

- anti H2 - po, inj.-ranitidina; IPP - omeprazol;

Pancreatita

1. Igieno - dietetic - intreruperea temporara a alimentatiei orale(1-2 zile)

2. Simptomatic - antispastice, antialgice, antiemetice, antiH2inj., IPP, antiacide, KCL 1-2 g/zi

3. Patogenic - PEV-cu Ringer, ser fiziologic, glucoza 5%, aminoacizi;

- AINS

- corticoterapie de scurta durata:prednison 1 mg/kg/zi 5-7 zile, dexametazona 0,4 mg/kg/zi 5-7 zile;

Orhita

1. Igieno-dietetic - regim alimentar mentionat anterior

- imobilizare la pat; comprese reci local (punga cu gheata)

- suspensor pentru testiculul inflamat

2. Simptomatic - mentionat anterior (la pancreatita)

3. Patogenic - mentionat anterior (la pancreatita)

Meningita, Encefalita urliana

1. Igieno-dietetic - mentionat anterior

2. Simptomatic - antitermice, antialgice, antiemetice, sedative, fermenti pancreatici, anticonvulsivante-fenobarbital, diazepam

3.Patogenic - AINS

- CORTICOTERAPIE - dexametazona -0,4 mg/kg/zi 2-3 prize/zi, 7-14 zile

-1 f la 12 ore

- solumedrol 2-4mg/kg/zi 2 prize/zi

-HHC-10 mg/kg/zi la 6h

-200-400 mg/zi la 6h

- ANTIEDEMATOASE CEREBRALE - manitol 20% 1-2g/kg/zi 3 zile

- furosemid 1-2mg/kg/zi, 1f la 12 h, 2-3 prize/zi

- glucoza 10 %, sulfat de Mg

- PEV cu vitamine B1, B6, C, calciu gluconic, reechilibrare volemica, H-E-Ringer, ser fiziologic, antiH2inj., antiacide, KCl 1-2 g/zi;

III. Durata medie de spitalizare - 10 zile