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1、SHIGELLOSISMaiLiDepartmentofInfectiousDiseasesTheThirdAffiliatedHospitalofSYSUDefinitionShigellosisisanintestinalinfectioncausedbyagenusofbacteriaknownasShigellathatcausesdiarrhealdiseaseofthecolonorlargeintestines.234EtiologyAgent:genusShigella:non-motile,non-spore-forming,Gramne
2、gativebacillus4species:AS.dysenteriae:13BS.flexneri:6CS.boydii:18DS.sonnei:1Viability:strong,1-3weeks,sensitivetomercuricchloride,5EpidemiologySourceofinfection：Reservoir:Humans/primatesCarriers,chronicpatients,AtypicalpatientsModeofTransmissionFecal-oral,Person-to-person,oral-gen
3、italIngestionofcontaminatedfoodand/ordrinkContactwithcontaminatedinanimateobjectsHousefliesEpidemiologySusceptiblepopulation:universe2nd,3rdyearEpidemicalfeaturesThepeakincidenceisinJulytoOctober67cellinvasionIntracellularmultiplyIntraandintercellularspreadHostcellkillingPathogene
4、siscolonicepithelialcellsEnterotoxin,cytotoxin,cytokine-mediatedinflammation,necrosisPathogenesis8pathologicalfeaturesoftheSigmoidcolonandrectumAcuteperiod：FibrindiffuseexudativeinflammationSeverecases:pseudomembranes,Ulcerationspolymorphonuclearandmononuclearcellsinfiltration,Mil
5、dcases:Diffuseedemaofcongestive,visiblemucusexudationofblood.Chronicperiod:Mucosaledema,bowelwallthickening,scarformation,polypformation,intestinalstricturePathogenesisofshigellosisinhumans910PathologicalfeaturesoftheSigmoidcolonandrectum11ClinicalManifestationsIncubationPeriodAve
6、rage:1-3(upto4)daysRange:12to96hours,upto8daysDiseasepresentation,severity,andcasefatality-dependentupon:HostBacterialserotypeandnumbersClinicalManifestationDiseasetypicalPresentation:Fever,nausea,vomiting,Dysentery(blood,mucus),frequent,small-volume,TenesmusAbdominalpain(lowerlef
7、tabdominalquadrants)12ClinicalManifestationTypicaltype:Mildtype:mildtoxemiaToxictype:shocktype,Cerebraltype,mixturetypeChronicBacillaryDysentery:≥2months13ClinicalManifestationTypicaltype:Acuteonset,highfeverAbdominalpainDiarrhea:stoolwithblood,mucus,non-mixedwithfecalmaterial,lit
8、tleamounteachtimeTenesmusLasts1-2
