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ID:19848514
大小:1.10 MB
页数:70页
时间:2018-10-07
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1、TyphoidFeverandParatyphoidFeverTyphoidandParatyphoidDefinitionEtiologyPathogenesisEpidemiologyClinicalmanifestationsThelaboratoryandotherexaminationsComplicationsDiagnosisanddifferentialdiagnosisPrognosisTreatmentPreventionsParatyphoidFeverDefinitionofTyphoidfeverAcuteentericinfectiousdisease
2、causedbySalmonellatyphi(S.Typhi).prolongedfever,Relativebradycardia,apatheticfacialexpressions,roseola,splenomegaly,hepatomegaly,leukopenia.intestinalperforation,intestinalhemorrhageEtiologySerotype:DgroupofSalmonellaGram-negativerodnon-sporeflagellaCulturecharacteristicsAntigens:locatedinthece
3、llcapsuleH(flagellarantigen).O(Somaticorcellwallantigen).Vi(polysaccharidevirulence)“wideltest”AschematicdiagramofasingleSalmonellatyphicellshowingthelocationsoftheH(flagellar),0(somatic),andVi(Kenvelope)antigens.EndotoxinAvarietyofplasmidsResistance:Live2-3weeksinwater.1-2monthsinstool.Dieoutq
4、uicklyinsummerResistancetodryingandcoolingEpidemiologycontinuestobeaglobalhealthproblemareaswithahighincidenceincludeAsia,AfricaandLatinAmericaaffectsabout6000000peoplewithmorethan600000deathsayear.80%inAsia.sporadicoccurusually,sometimeshaveepidemicoutbreaks.SourceofinfectionCasesandchroniccar
5、riersCasesdischargefromincubation,morein2~4weeksafteronset,afew(about2~5%)lastlongerthan3monthschroniccarrierTyphoidMaryTransmissionfecal-oralrouteclosecontactwithpatientsorcarrierscontaminatedwaterandfoodfliesandcockroaches.Susceptibilityandimmunityallpeopleequallysusceptibletoinfectionacquire
6、dimmunitycankeeplonger,reinfectionarerareimmunityisnotassociatedwithantibodylevelof“H”,“O”and“VI”.Nocrossimmunitybetweentyphoidandparatyphoid.SusceptibilityandimmunityAllseasons,usuallyinsummerandautumn.Mostcasesinschool-agechildrenandyoungadults.bothsexesequallysusceptible.Pathogenesisgastroin
7、testinaltracthost-pathogeninteractionsTheamountofbacilliinfection(>105baeteria).ingestedorallyStomachbarrier(someEliminated)entersthesmallintestinePenetratethemucuslayerentermononuclearphagocytesofilealpeyer'spatchesandmesenteri
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