细菌感染和病毒感染怎么区分 王淑颖 浙江大学医学院附属杭州市第一人民医院
细菌感染和病人感染区别，这样我们最初可以从病史的询问上面来进行区别，比如说流行病血史，接触史，比方说这个患者他拔牙之后出现的一个胃寒寒战高热，那我们首先要考虑细菌感染的可能性，比方说在流感季节冬春季节这个病人周围都是流感患者，他出现了一个发热考虑感染可能性我们首先考虑有病毒感染这个可能性，所以最初就是从病史的询问上面可以进行初步的判断，然后再进一步检查，我们会从患者的血项，最基本就是白细胞、中心粒细胞，如果是明显上升，这个都是提示细菌感染，如果白细胞、中心粒细胞都不高，淋巴细胞升高或者降低的，那我们往往就考虑病毒感染的可能性，特别是像淋巴细胞降低的，那我们要考虑病毒感染的可能性，另外，在我们的血液检查里面还有几个炎症指标，比如说我们的C—反应蛋白，超敏C反应蛋白。还有像降钙素原，我们医学术语叫做PCT检查，这个都是在血液方面相关的炎症指标以及我们的微生物学的检查，比如说，他的尿路感染做个节尿培养，如果考虑败血症做血培养，微生物检查帮助我们解决了很多问题，如果培养出来有病原菌，这个患者血项又是升高的，跟病人的临床症状是符合的，这个就完全支持细菌感染以及具体的系统定位，比如说肺炎、胸片或者CT检查，怀疑肝脓肿，腹部B超的检查，相关的影像学方面的检查，这些可以帮助我们来区别病毒感染以及细菌感染。
How to distinguish bacterial infection from viral infection
The difference between bacterial infection and patient infection, In this way, we can initially distinguish from the medical history, For example, the blood history of epidemics, Contact history, For example, this patient had a cold stomach and a high fever after he pulled out his teeth, First of all, we should consider the possibility of bacterial infection, For example, in the flu season, in winter and spring, this patient is surrounded by flu patients, He's got a fever, and we think about the possibility of infection, So initially, we can make a preliminary judgment from the medical history inquiry, And then further inspection, We'll take the patient's blood, The most basic are white blood cells, central granulocytes, If it's a significant increase, This is a sign of bacterial infection, If the white blood cells and the central granulocytes are not high, Lymphocytes that rise or fall, So we tend to think about the possibility of viral infection, Especially when it's like lymphopenia, Then we need to consider the possibility of virus infection, In addition, There are several inflammatory markers in our blood tests, For example, our C-reactive protein, High sensitive C-reactive protein. And like procalcitonin, Our medical term is PCT, It's all about inflammation in the blood and our microbiological tests, for instance, He has a urinary tract infection, and he's doing a section urine culture, If septicemia is considered for blood culture, Microbiological tests have helped us solve many problems, If there are pathogens in the culture, The patient's blood count is elevated, It's consistent with the patient's clinical symptoms, This fully supports bacterial infection and specific system positioning, For example, pneumonia, chest X-ray or CT, Suspected liver abscess, B-ultrasonic examination of abdomen, Relevant imaging examination, These can help us distinguish between viral infections and bacterial infections.
