Tropical fevers: Management guidelines.
Tropical fevers: Management guidelines.
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DOI：
10.4103/0972-5229.126074
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发表时间：
2014-02
期刊：
影响因子：
--
通讯作者：
Rungta N
中科院分区：
文献类型：
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作者：
From: The Indian Society of Critical Care Medicine Tropical fever Group;Singhi S;Chaudhary D;Varghese GM;Bhalla A;Karthi N;Kalantri S;Peter JV;Mishra R;Bhagchandani R;Munjal M;Chugh TD;Rungta N
热带热被定义为在热带和亚热带地区流行或特有的感染。其中一些发生在全年，有些尤其发生在雨季和雨季后。印度重症医学会（ISCCM）关注到这些感染造成的高患病率、发病率和死亡率、重叠的临床表现、难以做出具体诊断以及需要早期经验治疗等问题，成立了一个专家委员会，以制定在急诊和重症护理中管理这些疾病的共识声明和指导方针。根据印度现有的流行病学数据和该小组的总体经验，委员会决定重点关注最常见的感染。这些疾病包括登革出血热、立克次体感染/恙虫病、疟疾（通常是恶性疟原虫）、伤寒、钩端螺旋体细菌性败血症和常见的病毒感染，如流感。委员会建议采用“综合征方法”诊断和治疗严重热带感染，并确定了五种主要临床综合征：未分化热、发热伴皮疹/血小板减少症、发热伴急性呼吸窘迫综合征、发热伴脑病和发热伴多器官功能障碍综合征。提出了基于证据的算法来指导重症监护专家选择可靠的快速诊断模式和基于临床综合征的早期经验治疗。
Tropical fevers were defined as infections that are prevalent in, or are unique to tropical and subtropical regions. Some of these occur throughout the year and some especially in rainy and post-rainy season. Concerned about high prevalence and morbidity and mortality caused by these infections, and overlapping clinical presentations, difficulties in arriving at specific diagnoses and need for early empiric treatment, Indian Society of Critical Care Medicine (ISCCM) constituted an expert committee to develop a consensus statement and guidelines for management of these diseases in the emergency and critical care. The committee decided to focus on most common infections on the basis of available epidemiologic data from India and overall experience of the group. These included dengue hemorrhagic fever, rickettsial infections/scrub typhus, malaria (usually falciparum), typhoid, and leptospira bacterial sepsis and common viral infections like influenza. The committee recommends a ‘syndromic approach’ to diagnosis and treatment of critical tropical infections and has identified five major clinical syndromes: undifferentiated fever, fever with rash / thrombocytopenia, fever with acute respiratory distress syndrome (ARDS), fever with encephalopathy and fever with multi organ dysfunction syndrome. Evidence based algorithms are presented to guide critical care specialists to choose reliable rapid diagnostic modalities and early empiric therapy based on clinical syndromes.