【正文】 alarial paroxysm(發(fā)作) includes chills, rigors, spike fever（體溫驟升驟降）, and heavy sweating. The intervals are irregular in P. falciparum（惡性瘧）, within 48h in P. vivax（間日瘧）, and 72h in P. malariae（三日瘧）, respectively. Splenic enlargement is very mon.The diagnosis of malaria rests on the demonstration of the parasite in peripheral blood smears. Both thin and thick blood smears should be examined.13. the prerequisite for the transmission of schistosomiasis(血吸蟲病) .⑴ the unsanitary disposal of faeces, ⑵ the presence of suitable snail hosts, a⑶ human exposure to cercariainfected (尾蚴) water bodies.14. main manifestations of acute schistosomiasis?The majority of infected person are asymptomatic or have mild, nonspecific symptoms. Only 5 to 10 percent of infected populations have severe clinical symptoms. They include chills, spiking fever, generalized weakness, myalgia, headache, anorexia, profuse diarrhea, and weight loss. Extensive urticaria may occur in large patches on various parts of the body. Nausea and vomiting are mon and cough may be prominent. The fever usually lyses spontaneously 2 to10 weeks after onset.Physical findings are usually minimal but many include urticaria, patches of moist rales over both lung fields, generalized lymphadenopathy, and hepatosplenomegaly. Marked elevation of peripheral blood eosinophilia is mon.15．Hemodialysis indication :⑴Oliguric lasts〉4d，or anuria 〉24h⑵Concentration of blood urea nitrogen and creatinine increased:BuN〉⑶High catabolism ⑷Hyperkalemia, 〉6mmol/l⑸Pulmonary edema or hypervolemic stateCc15. Differential Diagnnosis of central nervous system infectionsMeningococcal Purulent Tuberulous Epidemic Toxic meningitis cerobrosoinal meningitis menigitis encephalitis Shigellosis Etiology Meningococcus Other bacterial Encephalitis B virus Shigelle Onset abrupt slow slow abrupt abruptAge 10year any age any age 10year childrenSeason Win.＆Spr. anytime anytime Sum.＆Aug Sum.＆Aug.Petechial mon rare no no noEarly shock mon rare no no monmeningeal irritation + + + + BR：WBC +++ +++ +/ + ++ N +++ +++ /+ + ++CSF: WBC ~ ~ normalGlucose ↓↓ ↓↓ ↓ normal normalChloride ↓↓ ↓↓ ↓ normal normalStoolroutine normal normal normal normal + main Difference Between G Septicemia and Typhoid FeverO G Septiemia Typhoid FeverOnset abruptly insidiously or slowlyToxic Symptoms severe slightGastrointestinal Symptoms seldom obviouslySpecific Toxic Symptoms seldom may be presentof Central Nervous System Primary septic focus may be present(50%) noDIC may be present noIncipient septic shock 40%patients may have noRash petechia predominantly rose spotDifferential Count neutrophilia lymphocytosisof WBCWidal`s Reaction negative positiveBlood Culture correspo