Sick K, 21, student, lives in dormitory. Fell sick sharply, daytime at 13 o’clock. Strong shivering, sickness and disappeared the appetite, appeared the headache, then pains S’hvathko abrazny

Sick K, 21, student, lives in dormitory. Fell sick sharply, daytime at 13 o’clock. Strong shivering, sickness and disappeared the appetite, appeared the headache, then pains S’hvathko abrazny nature were joined on the whole belly, more to the left. Since 16 hrs fluid formed stool 7 times, the last the last portions with slime. The following day increased weakness, disappeared the appetite, the temp of body increased up to 39c. Stool 15 times, nearly unformed, scanty in the manner of mucous festering komkab with prozhilkamy shelters. The pulling pains in rectum before and during defecation. False urges on defecation.

At check-up condition average severity. Pale. The skin net. The pulse frequent 100/min, satisfactory filling. The heart tones muted. In light change is not discovered. The tongue humid, is covered with whitish color. The belly soft and painful on move of the made someone look fat bowels, in left iliac area particularly.

Sick V, 24 yrs has entered for the 2^nd of disease with complaints on S’hvathko abrazny of pain in okolopupochnoi of the area, weakness, increasing temp up to 38.7c, shivering, sickness, frequent fluid stool up to 10 times per day, ample, greenish colour.

Per diet before disease he ate, eggs, sausage, sauce and beer.

Sharp pain, weakness, ↑ temperature with shivering 37.5*C, appearances of retching, stomachache. Frequent stool appeared in 2 hours. Condition was average gravity, pale, tachycardia. BP is 90 / 55 mmHg. Vesicular breathing, Tongue is dry with raid. Painful epigastrial area of abdomen in palpation. Peritoneal symptoms are negative. The liver and spleen is not increased

Patient P; 37 years, pain started after 2 hours after eating hot, smoked fish. Appeared dizziness, sharp weakness, pain in epigastrium, cramp like abdomen pain

Frequent retching, and then diarrhea appeared. He came to the hospital after 6 hours of disease. His condition is heavy. The patient was hyperemic. Lips are cyanotic. Pulse is 120 / min, weak filling. BP is 80 / 40 mmHg. Tones of heart are muted. The tongue is white coated. Abdomen is in correct form and participates in breathing. Peritoneal symptoms are negative.

During palpation rumbling and pain in umbilical region. The stool is fluid, smelly, ample and without slime.

Patient I; 16 years, entered the hospital 2 days after complains of cramp like pains in the lower floor of the belly. Liquid stools and weakness. The disease began with ↑ temperature 38.8 *C, dry skin, without rash. The tongue is covered by brown coat. Pulse is 92 / min. BP is 100 / 60 mmHg. Heart tones are mute. Vesicular breathing.

Abdomen is soft and pain in region of sigmoid colon at palpation. Liver and spleen is not ↑. The stool is liquid with slime and blood.

Patient K; 27 years, developed sharp pain after 4 hour after eating cake. Sharp weakness, shivering, sharp pain in the subcostal area. Retching was with food and bile later. The stool was every hour.

The condition was average grave. Diarrhoea and retching lasted with dizziness and weakness. Pulse is 116 / min, weak filling, BP is 90. 60 mmHg. Breathing rate is 28 / min, ↓ vesicular breathing. Tongue is white coated. During palpation developed pain in sigmoid colon. The stool was smelly without slime.

Patient D; 19 years is brought to the hospital 6 hors after beginning of diseases. The disease began with frequent ample retching and pain in epigastric area. Later appeared ample, fluid, smelly watery stool.the urges of defecation every 15 – 20 min

At arrival in hospital complained of pulling pains in muscles of lower limbs, sharp weakness, sickness and cramp like stomachache. ↑ temp 39.2*C. Very pale faded

Skin is humid, no rash, pulse is 130 / min, rhythmic, weak. BP is 90 / 60 mmHg. Heart tones are mute, ↓ vesicular breathing. Tongue is brown coated. During palpation there was pain in epigastrium and umbilical region. Spasm of sigmoid colon was present. The liver and spleen are not increased. Since the time of the disease he did not urinate.

Patient A, 19 years, a student living in a hostel. Besides him many other s tudents had frequent stool and they all treated themselves by Levomycetin

Student K, had sharp pain, headache, shivering, dull ache in body, the temperature ↑ 10*C. Later cramp like pains in lower abdomen and frequent stool 15 times per day. In the beginning stool was an admixture of faeces and slime., scanty an later there was no faeces in stool. Defecation was nerve wrecking, with painful urge.

Temperature was 39.5*C, sick pale. The tongue is dry and coated. The tones of heart are mute. BP 90 / 60 mmHg. Pulse is 130 / min, satisfactory filling. The abdomen is soft and painful on movement of large intestine. Sigmoid colon is spasmatic and painful

A woman worker in a pig factory, 39 years, suffers dysfunction of bowels in current 3 years. Seasonally the stool becomes fluid, with slime. About 5 times per day. This was accompanied with release of gas from abdomen, increasing temperature 37.2 – 37.5 * C, decrease of appetite, weakness. She didn’t see a physician, but treated by home facility. Noted deterioration last 6 months, lost weight, pulling pain in lower abdomen. The stool is 3 – 5 times per day with slime and sometimes with blood, tenesmus. Intensifies with inaccuracy of diet, like using fatty food.

At check up condition satisfactory, decreased feeding. The skin is pale, pulse is 83 / min. rhythmic, satisfactory, the heart tones are mute, and decreased vesicular breathing. The tongue is brown coated. During palpation and movement of large intestine it is painful. The liver and spleen are not increased.

Patient V; 43 years a nursery governess of the kindergarten. He doesn’t have any complains. In the group where he works, several children had intestinal dysfunction for 2 days. Patient V is examined as a contact.

Under objective examination total condition is satisfactory. Temperature is 36.6* C, Skin and mucosa is clear. On the part of cardiovascular and respiratory systems to pathology is not revealed. The tongue is humid, and coated at the root. The abdomen is soft, slightly painful in the sigmoid colon, during palpation. The stool is porridge like, with admixture of slime in the manner of turbio – sulphur flecks. The liver and spleen is not palpable.

Patient N, 29 years, has caused the physician on house in connection with sickness, the repeated retching and frequent liquid stools.

Sharp pain in the epigastrium at night, shivering, weakness, 2 times retching. After 1 hour, diarrhea started. The stool was ample, fluid, and smelly, from the time of disease 10 – 12 times. The pathological admixtures in excrements were not found.

In anamnesis chronic hypoacidic gastritis. Episodic abuses the alcohol. On the eve of the disease he took alcohol.

His condition was heavy, temperature was 38.8*C, pale, cyanosis of lips. The limbs are cold. Turgor of skin is decreased. Pulse is 110 / min, weak filling. BP is 80 / 40 mmHg. Tones of heart are mute. The tongue is coated white. The abdomen is slightly painful in epigastrium and right iliac region.

The liver and spleen are not increased. During examination, there was retching bile, and ample fluid stool with faecal contents and no slime.

Patient K; 32 years, pain started gradually; dull ache in body, headache, insomnia and loss of appetite. The temperature of the body was subfebrile and then gradually increased till 39.4 – 40 *C. at arrival to the hospital on 2^nd day, the disease condition was severe. Complains of headache and stomachache became severe. On examination he was pale, hypotonic, adynamic, bradycardia, heart tones are muted.

On the 10^th day of disease roseolar rash appeared. in lungs harsh breathing, dry single wheezes was heard. The tongue is coated. Pain in iliocaecal area and rumbling during palpation. In palpation of liver and spleen it is not increased.

Patient L; 29 years, has entered in hospital on 8^th day of disease. Weakness, malaise, moderate headache, bad dream, high temperature. The condition gradually became worse. The temperature was constant, intoxication symptoms (pallor, anorexia, clouded consciousness). Roseolar – papullar rash on skin of abdomen. Bradycardia, hypotonia, heart tones are mute. The tongue is coated brown, dry border of the defogging. The denominated flatulence, painfulness, in iliocaecal area, positive symptom of Padalki. The liver and spleen are increased.

On 22^nd day of disease sharp deterioration of the condition, twice was a retching, appeared stomachache, percutaneo - tone in right iliac area, weakly denominated pertitoneal symptoms

Patient D, 22 years, sharp pain in the night “contraction “ in the abdomen and unstoppable urge on defecation. The stool is ample, watery, light brown coloration 5 times during 3 hours. Appeared weakness, malaise, feeling of pressure in hypogastric area and retching with food once. On the eve of disease went to the country house and swam in the lake. He was hospitalized after 6 hours of disease. At arrival his condition is satisfactory. The temperature of the body is 37.2*C. skin is convered pale. Turgor of skin is good. The tongue is dry and white coated. Pulse is 82 / min, rhythmic, satisfactory filling. BP is 110/80 mmHg. Number of breathings is 22/ min the abdomen is soft, at palpation rumbling in right iliac area. One shot retching was noted in receiving quietness

Patient R; 35 years, after eating ham after preparation at home, noted sharp weakness. Dryness in mouth, diplopia, anisocoria, midriasis, ptosis, nistagmus, misty vision, constipations. On the 5^th day of disease shortness of breath, tachycardia, pain in the heart region and expansion of heart.

Patient K; 28 years, has entered to hospital on 2^nd day of disease with complaints of cramp like pain in the lower abdomen, dull ache in body and liquid stool and total weakness. The disease began increasing; the temperature is 38*C, appearance of headache and stomachache. Vomiting twice. After 3 – 4 hours from the beginning of disease appeared liquid stool. Patient is pale, temperature is 38.6*C. Skin is dry and without rash. The tongue is brown coated. Pulse is 90 / min. heart tones are mute. Borders of heart are not changed. The abdomen is soft, and at palpation painfulness in the field of sigmoid colon which was palpated in the manner of thick nodular fold. The liver and spleen are not increased. The liquid stool is with slime and flakes

Patient S; 30 years, disease began with increasing of the temperature of the body about 38 *C. Appearance of weakness and loss of appetite. At the following 5 days the temperature in the morning was 38.2* C but at night increased to 39.7*C, headache, completely disappeared the appetite, was noted delay of stool. He entered hospital for 7 days to able average gravity

During examination the temperature of body is 38.9* C, denominated adynamia. The skin is pale, dry without rash. In lung no pathology was revealed. Pulse is 68 / min. heart tones are mute. BP is 90 / 60 mmHg. Tongue is coated brown and the root more, on the lateral sides’ teeth imprints is seen. The abdomen is soft and inflated. liver and spleen are increased in size.

Patient D; 19 years, came with complains of cramp like pain in abdomen, frequent urges on defecation (at the 1^st 6 hours of disease stool is impossible to consider), headache, dizziness, shivering, increasing of the temperature before 39*C, From anamnesis is realized that the pain increased sharply 6 hours back, when appeared the above complains. During examination, the total condition is severe, wilted, pale, skin covers are dry, and clear. Pulse is 102 / min, rhythmic, satisfactory. Vesicular breathing. The tones are mute. BP is 90 /60 mmHg. The tongue is coated gray. The abdomen is inflated, and at palpation pain is noted, infiltration and painfulness of sigmoid colon is noted

Patient R; 34 years, with sharp pain in abdomen. Appeared total weakness, and break of the vision and couldn’t read the newspaper. Dry mouth on the 2^nd day of the disease, small flecks infront of the eye. On the 3^rd day of the disease a feeling of uneasiness in the chest during swallowing.(the fluid food pours out through the nose)

During examination; reduction of the vision of both eyes, diplopia, anisocoria, midriasis, ptosis, convergency. Palatal reflex is decreased. The voice was nasal. The stool was fluid for 2 days. Overnight before the disease ate smoked fish, prepared at home which was washed in the market

Patient Z, 57 years, sharp pain appeared in the morning with frequent watery stool, ample retching about 6 times. Cramps were joined in the gastrocnemius muscle, and in 10 hours he was in syncope.

At arrival he was complaining of pulling pains in gastrecnemius muscle and then weakness, dizziness.

His condition was grave. The temperature of the body is 36.2*C. skin covers are cold, cyanosis of the lips, tips of nose, acrocyanosis. The facial features sharpened, eyes sealed. Mucous membranes, mouth, conjunctiva are dry and hyperemic. The tongue is covered. The voice is weakened, husky talks with effort, and at times whisper. Convulsive twitches in gatsrocnemius muscle, foot and toes occurred. Turgor skin is reduced. The pulse is thready. BP is 60 / 40 mmHg. Breathing rate is 28 / min. The abdomen is inflated, painless, rumbling in palpation. The stool is watery and colourless, like rice water.

Ams: cholera.

Дата добавления: 2015-09-29