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ExposuresHistory of exposure to a patient with a similar illness is an important epidemiologic clue when determining etiology (eg, individuals who were in close contact with an index case of meningococcemia). Record evidence of systemic viral infection (ie, myalgias, fatigue, anorexia). Enteroviral infection is suggested by the presence of exanthemas; symptoms of pericarditis, myocarditis, or conjunctivitis; or syndromes of pleurodynia, herpangina, and hand-foot-and-mouth disease. Elicit a history of sexual contact and high-risk behavior from the patient. HSV meningitis is associated with primary genital HSV infection and HIV infection. A history of recurrent bouts of benign aseptic meningitis suggests Mollaret syndrome, which is caused by HSV. Animal contacts should be elicited. Patients with rabies could present atypically with aseptic meningitis; rabies should be suspected in a patient with a history of animal bite (eg, skunk, raccoon, dog, fox, bat). Exposure to rodents suggests infection with LCM virus and Leptospira infection. Laboratory workers dealing with these animals also are at increased risk of contracting LCM. The intake of unpasteurized milk and cheese predisposes to brucellosis and L monocytogenes infection. Дата добавления: 2015-09-18 | Просмотры: 431 | Нарушение авторских прав |