問題詳情

118. 一位50歲住院接受化學治療病患,因中性球低下發燒使用抗生素,治療期間發生腹瀉,臨床醫師懷疑為困難梭狀桿菌(Clostridium difficile)腸炎,下列敘述何者為非?
(A) 臨床上診斷感染性腹瀉,需包括連續2 天以上每天有3次不成形糞便
(B) 可以用核酸檢定toxin A或toxin B來確認感染
(C) 診斷需依賴內視鏡檢查及糞便培養
(D) 判定治療是否失敗,應至少使用6天藥物檢視治療效果決定
(E) 對較嚴重感染病患,如血液白血球數>15000/μL,首選使用口服Vancomycin

參考答案

答案:C
難度:計算中-1
書單:沒有書單,新增

用户評論

【用戶】.

【年級】大三上

【評論內容】A) (B)正確The diagnosis of CDI is based on a combination of clinical criteria: (1) diarrhea (≥3 unformed stools per 24 h for ≥2 days) with no other recognized cause plus (2) detection of toxin A or B in the stool, detection of toxin-producing C. difficile in the stool by nucleic acid ampli- fication testing (NAAT; e.g., polymerase chain reaction [PCR]) or by culture, or visualization of pseudomembranes in the colon (C)錯誤,因為也可以用檢測toxin A或toxin B或核酸檢測(D) 正確Although the mean time to resolution of diarrhea is 2–4 days,the response to metronidazole may be much slower. Treatment should not be deemed a failure until a drug has been given for at least 6 days.(E)正確Indicators of severe disease may include leukocytosis (≥15,000 white blood cells/μL) and a creatinine level ≥1.5 times the premorbid value.