Diagnosis of pseudotuberculosis in children
Last reviewed: 23.04.2024
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It is possible to suspect pseudotuberculosis in a patient with a combination of scarlatino-like rash with symptoms of damage to other organs and systems (liver, joints, GIT), especially with prolonged fever and undulating course. Winter-spring seasonality and group morbidity of people who eat food or water from a single source is important.
Bacteriological and serological methods of investigation are of crucial importance in diagnostics, especially if the disease is not accompanied by characteristic rashes.
Materials for bacteriological examination are blood, sputum, feces, urine and swabs from the oropharynx. The sowing of the material is carried out both for normal nutrient media and for enrichment media, while the ability of iersinia to reproduce well at low temperatures (refrigerator conditions) is used. Cereals of blood and rinses from the pharynx should be carried out in the first week of illness, feces and urine cultures - throughout the entire disease. Serological tests use RA, ELISA. For emergency diagnosis, PCR and immunofluorescence are also used. In practical activity, RA is often used, while living reference cultures of pseudotuberculosis strains are used as an antigen, and in the presence of an auto-stem, it is introduced into the reaction as an additional antigen. Diagnosis is a titer of 1:80 and higher. Blood is taken at the onset of the disease and at the end of the 2-3 weeks from the onset of the disease.
Differential diagnostics
Pseudotuberculosis must be differentiated with scarlet fever, measles, enterovirus infection, rheumatism, viral hepatitis, sepsis, typhoid-like diseases, etc.
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