melitaios piretos
apo brucella melitenesis( apo mi pasteriomeno gala i tiri i nosounta zoa)…sto eny exoume avksisi kitarwn kailefkwmatos fisiologiki glikozi
antidrasi Wright
orologikes eksetaseis pou anagnwrizoun tin brucella sto eny kai sto aima
therapeia brucellosis
rifampikini me trimethoprimi .soulfamethoksazoli i tritis genias kefalosporini
vaktiridio sifilis
wxra spiroxiati (treponima palladiium)
ti katastrefei i tritogonos simfili
nevriko kardiagkeiako alla kai kathe organo
okseia sifilidiki minigkitida diagnwsi
sto eni avksisi avksisi lemfokitarwn , leykomatos thetiki stin oroantidrasi VDRL(thetikes oroantidraseis)
Nwtiaia fthisis
15-20 xronia meta tin prwtomilinsi apo treponima palladum, mielorizonevropatheia,flegmoni stis opisthies rizes,ta nwtiaia gagglia kai opisthies desmes
argyl robertson (misi stin prosarmogi kai oxi sto fws)
stin nevrosifili kai stin diavitiki nevropatheia
farmako eklogis sifilis
penikilini(kristaliki penikilini G) se alergeia erithromikini kai tetrakiklini
nosos Lyme pou ofeilete
stin speiroxaiti Borrelia burgdoferi apo krotones (tsimpouria)
eny stin noso lyme
avksimena lemfokittara(3000) , avksisi lemfwmatos kai fisiologiki glikozi(opws vroukelwsi kai kapws stin sifili) ….diagnwsi me elisa
nosos pou prokaleite apo molismeni epafi me oura troktikwn
leptospeirwsi (leptospira interrogans)
therapeia fimatiwdous minigkitidas
isoniazidi , aithamvoutoli ,streptomikini , piridoksini (vB6)
simantikotero antimikitiasiko farmako
amfoterikini B(nefrotoksikotita ,anaimia)
toxoplasma gondi endokitario parasito varia vlavi pou mporei na kanei
diaxiti nekrwtiki egkefalitida
kata tin emvriiki loimwksi to toxoplasma kanei-
idrokefalia,mikroegkefalia ,epilipsia ,noitiki kathisterisi tiflwsi ,an ginei stin arxi to emvrio apovallete
therapeia toksoplasmatos
soulfadiazini kai pirimethaminis
oi iogeneis loimwkseis kanoun _ ston egkefalo enw oi bakritiakes kanoun _
diaxati prosvoli(ektos hsv1 topika) ————topiki logo nekrwsi kai mporei apostima
poia einai ta pathogona mikrovia okseias piwdous minigkitidas(flwgmoni ston iparaxnoeidi)
pnevmoniokokkos (>20) , miniggitidokokkos(paidia kai neous enilikes) , listeria se ilikiomenous kai anosok , aimofilos 10%
pathofisiologia minigkikis loimwksis
1.apo mikrovia fisiologikou apoikismou tou rinofarigga pou pernoun ton aeff 2. epektasi paraminiggikis loimwksis 3.miniggiko rigma 4.xeirourgiki epemvasi 5.riksi egk apostimatos
kliniki eikona okseias piwdis miniggitidas
piretos ,isxii kefalalgia ,diskampsia evxena epiliptikes kriseis ,kerning brudzisky
exoume mesi otitida kai minigkitida,apo poio organismo
pnevmoniokokkos
se kak ti pathogono gia minigkitida
stafilokokkos
ti kanoume se piwdi minigkitida
kaliergeia aimatos kai empeiriki antiviwtiki agwgi,onp(prwta ct se ipopsia xorokataktitikis eksergasias) afta paraklinika
poia einai i empeiriki antimikroviaki therapeia se okseia piwdi miniggitida
kefalosporini tritis genias (kefotaksimi kai keftriaksoni) kai vankomikini gia pnevmoniokokko ,streptokokko b kai aimofilo ….listeria -ampikillini ……stafilokokkos i psevdomonada vankomikini+ kseftazidimi
gia aftous pou prepei na kanoun ximeioprofilaksi apo piodi miniggitida(miniggitidokokiki)
rifampikini minokiklini soulfadiazini
kliniki eikona apostimatos
simeia xorokataktitikis eksergasias,endokrania ipertasi ,estiakes epiliptikes kriseis,apiretos (xamilos), sos onp oxi!! ,defterogenis epilipsia simantikoteri epiploki
pou vriksete to empiima kai ti kanei
iposkliridio xoro,thromvoflevitidws kolpwn
episkliridio apostima
apo osteomielitida kraniou ,vgenei pio apo afti ,provlima sto tridimo kai apagwgw sixnotero pathogono xrisizon stafilokokos
nevrosifili meta apo 15-20 xronia kanei nwtiaia fthisi poia einai ta simptwmata(mielorizonevropwtheia)
aftomata keravnovola algi kiriws katw akrwn, aisthitiki ataksia,diataraxes ourisis,simeia: argyl robertson ,apousia antanaklastikwn katw akrwn ,thetiko romberg
diagnwsi toksoplasmatos
ct :pollaples asvestopoiimenes esties ,elisa( kai lyme)
iogeneis loimwkseis n.s
pathogenesi eitai kanoun miniggitida,eitai prosvoli faias ousias polioegkefalitida, mono se prosvoli nevrwnwn prosthiwn keratwn n m poliomielitida kai lefkoegkefalopatheies(otan pan oi ioi sta gloiaka kitara kai kanoun apomielinwsi)
okseia iogenis miniggitida
piretos ,kakouxia ,kinagxi ,kefalalgia ,fotofovia,ipnilia ,ipia i katholou miniggika simeia
eni stin okseia iogenis miniggitida
afksisi lemfokittarwn mikri avksisi lefkwmatwn ,kai glikozi fisiologiki
se poies loimwkseis exoume fisiologiki glikozi sto eny
brukelwsi lyme kai okseia iogenis
pio varia apo oles tis iogeneis egkefalitidees einai i loimwksi apo
io tou aplou erpita tipou 1(sto ieg kanei oksiaixma kimata megalou ipsous ana 2-3 sec) therapeia akikloviri
o vzv erpitoios(akiklobiri),otan epanenergopoiithei analoga me to simeio pou kanei vlaves
gasereio gagglio(v1) ston ofthalmo ,eripis gonatwdous swmatos (vii) rumsay hunt-paralisi prosopou kai fisalidwdes eksanthima limwksi nwtiaiwn gaggliwn(aisthitikwn) sinithws th3-th12 fisalides ,algi rizitikis katanomis
proodevtiki poliestiaki lefkoefkefalopateia
apo io papova JC ,nevrotropos gia oligodendrokittara ,aftos kanei apomielinwtikes esties se imisfairia stelexos paregkefalida agwgi me: CIDOFUVIR
ti simvainei se ena pou exei ipokseia sklirintiki panegkefalitida
aftos epathe lipwksi apo ilara se ilikia mikroteri 2 etwn,lanthanon xronos 5-6 xronia ,ekptwsi iq ,ataksia miokloniki kwma ,sto eny exoume g sfairines kai antiswmata kata tis ilaras
poios ios kanei tropiki spastiki tetraparesi
HTLV-1
TI klinika sindroma apo n.s tha kanei o hiv
asipti miniggitida,hiv egkefalopatheia(prosvoli lefkis ousias) ,mielopatheia(spastikotaksiki sindromi) ,prosvoli periferikou n s (gb i cidp)
poio einai to sixnotero loimogono aitio miniggitidas apo aids
kriptokokos
ti kanei tis spoggwdeis egkefalopatheies
ta prions (nosos creutzfeldt -jakob)
oi nosoi prion( einai eitai sporadikoi eite klironomikes einai apotokes molinsis)
exoume diataraxi metavolismou prion prwteinis,fisiologiki PrPc nosogonos PrPSc(PRNP gonidio) .i nosogonos morfi den diaspate apo enzima kai kanei inidia SAFs enonontai kai kanoun amiloeides –> plakes –> egkefaliki vlavi
pathan prions nosou
spoggomorfi ekfilisi,astrogloiwsi ,apousia flegmonis
kliniki eikona kai parakliniki eksetasi spogodoys egkefalopatheias
ekptwsi noitikwn leitourgeiwn ,thanatos entos 6-12 minwn,xaraltiristika: mioklonies prwimi anoia ekfortiseis ieg,sto eni exoume prwteini 14-3-3