183.2 📚 國考版

183.2.0.1 必背 — Risk

• Tropical, 颱風 / 洪水, 農業, 動物接觸, 水上活動

183.2.0.2 必背 — Phase 1 Clinical Clues

• Conjunctival suffusion (red eye, no exudate)
• Calf myalgia (severe)
• 高燒 + 頭痛

183.2.0.3 必背 — Severe (Weil’s Disease)

• Jaundice + AKI + 出血
• ± SPHS (Asia variant, ARDS)
• Mortality 5-15%

183.2.0.4 必背 — Dx

• MAT serology (gold standard, paired)
• PCR blood (early), urine (late)
• IgM ELISA rapid
• Hypokalemia + disproportionate bilirubin clue

183.2.0.5 必背 — Treatment

• Mild: doxy 100 bid × 7d
• Severe: ceftriaxone 1-2 g IV qd × 7d or PCN G IV
• Doxy-PEP 200 mg weekly for high-risk

183.2.0.6 必背 — Prevention

• Avoid contaminated water
• Protective gear
• Animal vaccination
• 通報

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