- is the basis for rational and effective treatment of the patient;
- allows in most cases to anticipate possible options for the further course of the disease and its consequences;
- allows for timely and adequate anti-epidemic and preventive measures.
1. Should be carried out taking into account the clinic and epidemiology.
2. Must be anti-epidemic and preventive - early diagnosis is needed not only for timely treatment, but also for timely anti-epidemic and preventive measures aimed at preventing the spread of the disease, prevention of nosocomial infections.
- amnestic method (patient complaints, medical history, life history and epidemiological history);
- objective examination of organs and systems of the patient.
Paraclinical:
- specific methods (laboratory) and structural and functional (instrumental) diagnostics.
Complaints of the patient should be collected carefully, because in many cases it makes it possible to suspect a particular infectious disease. In the presence of dyspeptic manifestations (nausea, vomiting, diarrhea) it is necessary to find out what is related to their occurrence, the frequency of vomiting or defecation, their nature, volume, the presence of pathological impurities. They ask about the place and intensity of pain (head, abdomen, muscles, joints), sleep disorders, etc.
The anamnesis is an elucidation of features of development of a disease, definition of the leading symptom, definition of complications. Sometimes a well-collected history allows for diagnosis. The anamnesis of the disease should be collected in detail and actively. It is impossible to limit oneself only to the patient's story, it is necessary to ask him in addition: about the peculiarities of the beginning of the disease, how the disease developed in the future, in what sequence and when the main signs of the disease appeared; what treatment the patient received at home, because it could significantly change the clinical picture.
- Provides clarification on the transferred diseases
- The presence of chronic diseases
- Tuberculosis
- Diabetes
- Allergy history is important
- The presence of bad habits
- possible source of the pathogen;
- the route of infection and the likely susceptibility of the person who became ill;
- possible contacts with patients with similar clinical signs;
- communication with persons who came from an epidemically unfavorable area;
- possible contact with animals;
- information on food consumption (when and where they were purchased, how long and in what conditions they were stored, what dishes were prepared from them, time and place of consumption, who still used questionable foods and how they feel);
- water supply conditions, drinking water quality and sanitary condition of the area where the patient lives;
- whether the patient follows the rules of personal hygiene;
- profession of the patient, his age, state of health before the disease;
- season, geographical and climatic conditions;
- what infectious diseases have you had in the past;
- information on preventive vaccinations.
- general condition of the patient;
- skin color and elasticity;
- soft tissue turgor;
- body temperature
- consciousness (impaired in patients with meningitis, encephalitis, hepatic encephalopathy);
- behavior (agitation in typhus, aggression in rabies);
- Assessment of the patient's speech and voice.
- appearance and facial expression (can be very characteristic of tetanus - sardonic smile);
- body position (opisthotonus when editing, meningeal posture - head tilted back);
- Paleness - with vasospasm, bleeding, blood deposits in the vessels of the abdominal cavity (shock).
- Hyperemia, mainly of the face - with hemorrhagic fevers pseudotuberculosis, typhus.
- Jaundice - deposition of bilirubin pigment in the skin - with viral hepatitis, hemolytic anemia.
- Moisture of the skin - excessive sweating, occurs during a critical decrease in body temperature in brucellosis, malaria, sepsis.
- Dry skin is caused by large fluid losses in cholera.
- Elasticity (turgor of the skin) is determined by taking the skin in the fold of the abdominal wall and the extensor surface of the arm. Normally, the fold disappears quickly, in the case of reduced turgor (dehydration) does not straighten for a long time.
Laboratory methods of examination include general clinical tests, which include general blood tests, general urine tests and fecal tests. Laboratory methods of examination also include biochemical methods of examination, which determine the level of glucose, creatinine, urea, bilirubin, liver enzymes, blood lipids; coagulogram, which analyzes the indicators of blood clotting; blood hormone tests; determination of tumor markers; tests of blood and other biological materials for infectious diseases; allergological, toxicological, cytological and parasitological examinations.
Instrumental methods of examination include X-ray, endoscopic, ultrasound, methods of recording the electrical activity of organs and a number of other methods of examination.
