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Diagnosis of pseudotuberculosis: analyzes, differential diagnosis

, medical expert
Last reviewed: 23.04.2024
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Clinical diagnosis of pseudotuberculosis is complex in case of sporadic morbidity and becomes relatively simple in flare. It is based on the characteristic clinical symptoms and laboratory diagnostics.

trusted-source[1], [2], [3], [4], [5], [6], [7],

Indications for consultation of other specialists

The same as in yersiniosis.

Specific and nonspecific laboratory diagnosis of pseudotuberculosis

In the hemogram, neutrophilic leukocytosis, monocytosis, eosinophilia is detected. Relative lymphopenia and an increase in ESR. In the biochemical analysis of blood, increased activity of enzymes, less often - hyperbilirubinemia. Specific laboratory diagnosis of pseudotuberculosis is the same as in yersiniosis. Promising methods of specific diagnostics are the immunoenzyme test system based on the porin Y. Pseudotuberculosis protein and erythrocyte antigenic diagnosticum for RIGA based on cell wall proteins Y. Pseudotuberculosis.

Instrumental diagnosis of pseudotuberculosis

Additional instrumental diagnosis of pseudotuberculosis does not differ from those described for iersiniosis.

Example of the formulation of the diagnosis

  • A28.2. Pseudotuberculosis, abdominal form, terminal ileitis, moderate severity.
  • A28.2. Pseudotuberculosis, secondary focal form, erythema nodosum, moderate severity, prolonged course.

trusted-source[8]

Differential diagnosis of pseudotuberculosis

Differential and diagnostic signs of abdominal pseudotuberculosis and acute appendicitis

Symptoms

Abdominal form of pseudotuberculosis

Acute appendicitis

Epidemiological data

More often in the spring, late winter and early summer. Characteristic of group cases

Sporadic cases, without seasonality

Onset of disease

Acute, feverish chills, severe intoxication and abdominal pain

Stage: first pain in the abdomen, then increasing intoxication and fever

Skin and mucous membranes

Hyperemia of the palms, feet, face, neck of the mucous membrane of the throat and conjunctiva

Most common or pale

Exanthema

Typical

Not visible

Language

"Crimson"

Lined, dry

Abdominal pain

More often, from the 2nd to 4th day of the disease, paroxysmal

From the first hours of illness, constant

Nausea and vomiting

They rarely do not depend on abdominal pain

Often especially in children. Arise after the onset of abdominal pain

Symptoms of irritation of the peritoneum

Rare, pronounced vaguely

Characteristic, expressed

Enlarged mesenteric lymph nodes

Often

Not visible

Symptoms of parenchymal hepatitis

Often

Not typical

Body temperature

Febrile, reaches a maximum in the first day

Increases gradually, more often subfebrile

Increased ESR

Characteristically

Not typical in the absence of complications

Differential diagnosis of pseudotuberculosis, trichinosis and drug dermatitis

Clinical signs

Differential diseases

Pseudo-tuberculosis

Trichinosis

Drug dermatitis

Start

Acute, can be gradual

Often acute

Acute

Fever

More often febrile, 1-2 weeks

Remittent, permanent or incorrect type. It grows within 1-2 weeks. Reduces gradually, Rarely subfebrile condition up to several months

Subfebrile. Can be a normal temperature

Intoxication

Expressed from the first day, prolonged

Expressive, prolonged

Not expressed

Exanthema

Polymorphic, sometimes with hemorrhages. From the 2nd-4th day of illness, mainly on the trunk of the limbs, palms, feet, against the background of hyperemia, sometimes itchy. Can be nodosum erythema, After the disappearance of the rash - peeling

More often macular, draining, is saved 5-8 days, then a pigmentation and an ecdysis. There is no characteristic localization and staggering of rashes Sometimes itchy. Several waves of rashes are characteristic

More often macular, korepodobnaja, after reception of medicines. Itchy, draining. Disappears after drug discontinuation

Scleritis and conjunctivitis

Characteristic

Conjunctivitis with hemorrhages in the stage of periorbital edema

Often

Hyperemia and puffiness of the face

Characteristic

More often the puffiness of the face (especially with normal skin color

Puffiness, burning sensation of the face without hyperemia

Abdominal pain

Cramping or constant, aching in ileocecal angle and near navel

In severe conditions

Sometimes, spilled

Diarrhea

Typical

In severe conditions

Occurs rarely

Jaundice

With the development of hepatitis, a mild, short-term

Possible

Can not be

Raspberry tongue

Characteristic

Characteristic

Rarely - red, without hypertrophied papillae, "geographic"

Arthralgia

Typical

Can not be

Rarely

Hepato-lienal syndrome, polyadenopathy

Characteristic

Characteristic

Rarely

Renal damage

Sometimes pyelonephritis with scant symptoms

Not typical

Rarely - allergic nephritis

Changes in the hemogram

Moderate neutrophilic leukocytosis, relative lymphocytosis, eosinophilia. Increased ESR

Leukocytosis, eosinophilia (up to 60%) for 2-3 months

Nonspecific. Rarely moderate eosinophilia

Myalgia

Typical

Pronounced, Appears in the extremities then in the muscles of the pharynx and chewing muscles

Rarely

trusted-source[9], [10], [11], [12], [13]

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