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File: 123096_sep96_decls23_0015.txt
Subject: DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANCE
Unit: OTSG
Parent Organization: HSC
Box ID: BX003203
Folder Title: DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Document Number: 1
Folder Seq #: 88
B. Signs: a. Skin snips of rose spots: may be posi-
1. Fever! remittent, 40CL- (104'F); 75 - 100*. tive when cultures of other sites fail
2. Pulse slow relative to fever. to isolate organism.
3. Rose spots: 2 - 4 mm blanching erythematous,
maculopapular lesions; occur in crops of about 10; 5 . Serologic: limited value-insensitive and non-
located on upper abdomen; lasting several hours to specific.
several days; appearing 7 - 10 days into illness;
13 - 46%. 6 . Coagulation: usually normal. Occasionally
4. Hepatomegaly: 15 - 50% coagulopathy, with prolonged prothrombin time (PT)
5 . Splenomegaly; often tender: 40 - 64% and partial thromboplastirl time (APTT) may be
6. Neurologic/mental status changes: Including seen.
lethargy, stupor, coma, seizures, delirium,
meningismus; 10%. 1). X-ray: chest x-ray normal (infiltrates in <10%).
7. Pea soup" stools: loose, pale stools; 25%. E. Invasive procedures:
C. Laboratory: 1. Bone marrow aspiration, for culture, as above.
2. Skin snip or biopsy of rose spot, for culture, as
a. Hgb/Hct: anemia common, worsens progressively above.
over first three weeks@
b. WBC: normal in 75% (range 1,200 - 20,000). F. Diagnostic confirmation: isolation of organism from
0. Platelets: usually normal, occasionally low. blood, marrow, or skin. Isolation from stool of a
d. ESR: typically elevated. typical case is presumptive evidence, but not defini-
tive.
2, chemistries:
a. SGOT, LDH: mild/moderate elevation in about IV. Duration:
33%.
b. Alkaline phosphatase: mild elevation common. A. Treated: 4 - 5 days, until defe"escence; 2 weeks
C. Bilirubin: mild elevation (two-fold) common; therapy required.
sufficient to cause jaundice, uncommon.
d. CPK: occasionally elevated. B. Untreated: 4 week acute illness, if not complicated.
3. Urinalysis: nonspecific. V. Complications:
4. Microbiologic: causative organisms include Sal- A. intestinal perforation:
monella tylphi (typhoid), other salmonella species 1. Incidence I to 10%, typically during second or
third week of illness.
sinia nterocolitica, Yersinia Pseudotub rcu@losis 2. Mortality: 25%.
and CampYlobacter fetus. 3. Signs:
a. Blood cultures: I) first week 80% posi- a. classic peritoneal signs often absent.
tive; by third week 20-30% Positive; II) b. abdominal x-ray shows free air below dia-
obtain 2 to 3 sets for optimal yield. phragm.
b. Bone marrow aspirate cultures: 90-95% C. absent bowel sounds and vomiting, suggesting
positive. ileus, may be most prominent clinical fea-
C. Stool cultures: occasionally positive tures.
during incubation; 33-67% positive 4. Perforations may be single or multiple.
during weeks 2 - 4 Of illness. 5. Ileum is most common location.
d. Urine culture: intermittently positive 6. Treatment is surgical.
after second week of illness in 25%.
Multiple specimens should be sent. B. GI Hemorrhage:
1. Incidence: 1-20% depending on initiation of
antibiotics.
2. Mortality: low if recognized and treated.
2 0 21
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Document 52 f:/Week-36/BX003203/DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS/diagnosis and treatment of diseases of importanc:12179609281524
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Folder Seq # = 88
Subject = DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANC
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996