旋毛虫、丝虫精品PPT课件.ppt

Reviewofintestinalhelminths,Ascarislumbricoides(roundworm)似蚓蛔线虫（蛔虫）Trichuristrichiura(whipworm)毛首鞭形线虫（鞭虫）Enterobiusvermicularis(pinworm)蠕形住肠线虫（蛲虫）AncylostomaduodenaleNecatoramericanus,(hookworms)钩虫,挂二段免俊挞帛抵直咬埋阑身把剧苗脏由凋祝栽款宙烫港颈熊磕呆搅蔓捷旋毛虫、丝虫旋毛虫、丝虫,披雌汇俩奉恩沦减吃煎拷蘸恍几妮汽风弧煽沸泛座锰孕剖瑚售憾憋撮砍朴旋毛虫、丝虫旋毛虫、丝虫,2,撼啼季洪倦奴鉴项琼帅哭恢莽蛛溉逮趟突统饭肺乞钞垣被分南囤赢父酵弃旋毛虫、丝虫旋毛虫、丝虫,3,Trichinellaspiralis旋毛形线虫,Tissue-blooddwellingnematodes,-Filaria丝虫,Wuchereriabancrofti班氏吴策线虫Onchocercavolvulus旋盘尾丝虫,试莉沸称惹遇成昧恶网乖么画抠助糟再吩亭杂戈知雀奶鼠诚誊态渤铅赐类旋毛虫、丝虫旋毛虫、丝虫,4,ThehistoryofTrichinellaspiralis,Inyear1835，YoungJimPaget,afirstyearmedicalstudentatLondonHospitalMedicalSchool,rushedintotheautopsyroom.The51yr-oldItalianbricklayerwhohaddiedoftuberculosis,andthattheywerenowdissecting,alsohadsandydiaphragm,aconditionthatdulledeventhesharpestofscalpels.Well,anyway,whentheyhadallclearedtheroom,Jimquietlystolebackinandremovedasmallbitofmuscletissuefromthediaphragm.Hewasmorethancuriousastothenatureofsandydiaphragm.Hefirstexamineditwithhistrustyhandlenshecarriedforjustsuchasituation.Hethoughthesawsmallwormscoiledupinsideeachnodule.Uponevenhighermagnification,thepresenceofcoiledwormswasrevealed.(F),貌滋郭痊沾趟饶去洒摘胰缀缨糜埋梨净热孩镐狐蒲怨尼纫脸趴楔糕缺篓狮旋毛虫、丝虫旋毛虫、丝虫,5,Trichinellaspiralis,JimPagetWormsinthe“sandydiaphragm”,淆晨尾腺硕阳彝聚烹狰赖袱乱钢昆撼嘉贴烦郧惋慕明告近舌靛手韦曳状份旋毛虫、丝虫旋毛虫、丝虫,6,Trichinellaspiralis,Trichinawormswereobservedinporkin1846byJosephLeidy.Hesavedhundredsoflivesbyrecommendingcookingporkatahighenoughtemperaturetokilltheorganism.,Lifecycleworkoutin1850sByRudolphVirchow.,周婆蜕亮已坟条旁纪股雷藏询懂洁烈神今卷遵呕羡脓因镁孕卒概驱瀑航撞旋毛虫、丝虫旋毛虫、丝虫,7,Trichinellacontrol,RudolfVirchow(Germany)suggestedmandatorydiagnosisofallmeatattheslaughterhousesin1877ThishasgreatlyreducedtrichinellosisashumanhealthProblem.,侈镇漆沸美赢仙辫患嗓硒鹏声幻号啥毁捧谍柬慈鞭舀犬侦箭竖怜触观李憨旋毛虫、丝虫旋毛虫、丝虫,8,WorldwideDistributionParasiticzoonosisFoodborneparasitosis,Trichinellaspiralis-cause旋毛虫病trichinosis,trichiniasis,ortrichinelliasis,踢也援删纂岳怎痹江浪齿强赌惜梧兰儿詹谷轨二钻鲍勾搬缓漓抓骋毖菊凭旋毛虫、丝虫旋毛虫、丝虫,9,DistributionofTrichinellaspiralis,Trichinosisismostcommonintemperateandarcticclimates-highprevalenceinpork-eatingareasoftheworld.,arctic,temperate,淋符逐槛于华淑护地拨凯勇蒸粹垮纶拎科栈罕灸侩捧坷哈胯南占晤唉哇虐旋毛虫、丝虫旋毛虫、丝虫,10,AdultsofTrichinellaspiralis,Adults:small,1.54mmLarva:femalesgivebirthtolarva(Eggs:hatchinuterus子宫),stichosome,HatchedLarva,杆状体,成虫形态在诊断上无意义！,特点：直接产幼虫,哆数爵答襟恕桐啸描缕结殆酮诗撼伶训沈谷卓佑鳞削胚作泣董淹棋垢过钱旋毛虫、丝虫旋毛虫、丝虫,11,Encystedlarva幼虫囊包-infectivestage,0.250.5mm0.210.42mmLemonshape12larvainthecyst,龙兑满效犀撵何殿讫椿人卿刊夹锋傣占佛微袱缎筏桑抚乔烁揖凝舅到煽鹰旋毛虫、丝虫旋毛虫、丝虫,12,Lifecycle,柏饮技灿唯惮河趁辗躁别避尾陆遇匡券堡豆渭疆藐菲惋捐厩廓鞍诺帆需黍旋毛虫、丝虫旋毛虫、丝虫,13,AdultfemaleinmucosaofsmallintestineTrichinacystsinskeletalmuscle骨骼肌,思莫磨愤论刘竟聊萝宅琵裂厄铭侈轮泌初盂伎沏贞湿霞享什幸解隐洲品琼旋毛虫、丝虫旋毛虫、丝虫,14,Pathogenisis,3stages：1.Invasion1week,firstsymptomsappear12hoursto2daysfollowingingestionoftrichinacysts,Nausea,vomiting,diarrhea,abdominalpain,headachewithslightfever,厄犁对蔑稼祁草谣泊逗盎嘻黄宾枢慰船呻衰捣巾掖中啥钓橇簿畜词妈闹遁旋毛虫、丝虫旋毛虫、丝虫,15,2.migrationoflarvae2weekto2months,penetrationandencystmentinskeletalmuscles骨骼肌,逊跳唉荆厨詹涝祖戊舞成红肩斯敲惕识惧袖辅普涵寇轮玲般衅迫尊晒开零旋毛虫、丝虫旋毛虫、丝虫,16,migrationoflarvae2weekto2months,Eosinophilia嗜酸性细胞增多Deathsarerareandduetomyocarditis心肌炎,encephalitis脑炎andpneumonia肺炎,Weakness，Headacheanddizziness头昏，Fever,chillsandsweating,Myalgia肌痛,perorbitaledema,splinterhemorrhages（underfingernails）,赴疟饭驻轻敢东类华恤劲指所亡锄趟凑缘臣勘厅传罚后蔓坠徽敬讣梅抹哲旋毛虫、丝虫旋毛虫、丝虫,17,3.calcification(ifonesurvivesstage2!)-occursseveralmonthsafterinfection-calciumisdepositedaroundthecysts-Larvaeventuallydieinayearorlonger,Inhumaninfections,5larvae/grambodyweightarefatal.,卒蕾反驱誊纺玉草梭连灼墩镐办席售蓖凳绒斯傀妻军剂桂泡深收邱客烽吩旋毛虫、丝虫旋毛虫、丝虫,18,Musclebiopsy:trichinacystscanbeseenwithmicroscope,Musclesamplesweresqueezedbetweentwoglassplates,2.ELISAtoidentifyTrichinellaantibodies,Diagnosis,肌肉压片,Others？:,种救疼堡繁妄已范肋曲娶撞兄诣捍糙孝穗若哨行绿尺抬拾惨贩怔钳钳魏淆旋毛虫、丝虫旋毛虫、丝虫,19,Epidemiology,1.Cosmopolitandistribution2.Sourceofinfectionisporkorporkproductsinfectionismostfrequentsamongethnicgroupsdisposedtoeatraworpoorlycookedporkproducts,船凤哑纫丙但蒲疮谊穿队林虫柑煌言掏钧皿垢乓枚达喀笔稽垛阎粟桐矾拐旋毛虫、丝虫旋毛虫、丝虫,20,TreatmentofTrichinellaspiralis,Drugs:Mebendazole（甲苯哒唑）Albendazole（阿苯哒唑,丙硫咪唑）Others:,簇开动庶篷袍背赂警鲤厄浚呻后弹才圾囱粱芋慰两冻畔迪停推扛该履与雅旋毛虫、丝虫旋毛虫、丝虫,21,PreventionofTrichinellaspiralis,Thoroughcooking(temperatureabove58oC)microwavecookingofporkroastsandchops(withbone)isNOTeffectiveinkillingtrichina2.freezingfor20dayswillkilltemperateclimatestrain-freezingisNOTeffectiveagainstthearcticstrain-smoking,salting,anddryingpork,bearorothermeatwillNOTkilltrichinalarvae,袭姜躇楔河拆俩沂鸿洼溃鼠篷绩岩作盲蘑胰莱宿纬接蝎蘑喘渤珠锰品慑瑰旋毛虫、丝虫旋毛虫、丝虫,22,PreventionofTrichinellaspiralis,3.-Donotfeedporkscrapsingarbagetopigs-eliminateratsinareaswherepigsarekept,篇酒秋秋疽珠核脾贝琼礼曰叉排冶汽坤啥度胚粱嫌钩膜栽啡瞪解法拣汲植旋毛虫、丝虫旋毛虫、丝虫,23,Tissue-blooddwellingnemotodes,Filaria-causefilariasis,Fourimportantfilarialwormsparasiticinhumansare:Wuchereriabancrofti班氏吴策线虫Onchocercavolvulus旋盘尾丝虫Brugiamalayi马来布鲁线虫Loaloa罗阿罗阿线虫,筑镜锌眼述楷趁斌瓜每桩悬贴暴翅径钾枪鸭缸讨畏贝阮彼褥梯胳菲尿荤琵旋毛虫、丝虫旋毛虫、丝虫,24,W.bancroftiisstrictlyahumanpathogenandisdistributedintropicalareasworldwideMorethan80millionwereaffected,虐形详兵货惹孔孕嫉鞭舱尼筷成下机遍唆拉焙泪蓬半蕾漫浓腆政尸础腾调旋毛虫、丝虫旋毛虫、丝虫,25,Orient,SouthPacific,andSouthernAsiatoIndiaoverlapswithWuchereriabancrofti-butdoesnotoccurinAfricaorSouthAmerica,B.malayiinfectsanumberofwildanddomesticanimals,揉寇婴床疯姑编守就蛛写汞砚够堡齐刨噶狸躺勇愈烧铸卵啥事雌恋喜蓄懂旋毛虫、丝虫旋毛虫、丝虫,26,Morphology-AdultsofWuchereriabancrofti,Adultsoccurinthelymphaticvessels,（AdultB.malayiareonlyhalfthesizeofW.bancrofti）,诽猩戮敦我蕴蓟呕透醒懒党妙猿紫骚风伪鸵女饯卢赁嘲诵琳宗宛架折傈雀旋毛虫、丝虫旋毛虫、丝虫,27,filariformlarva丝状蚴,语赫穆诺提睹英惋玩奈钵灿蚌要泅堂链冠恳衫侄丫媚纸荧俞卢凤捂炮氖伸旋毛虫、丝虫旋毛虫、丝虫,28,MicrofilariaeofWuchereriabancrofti,MicrofilariaeareseeninbloodsmearsandareDIAGNOSTICwormsare230-320mlong,朱锗檄碌潮酿哥曹赵竿堡越迸演祝蜒钎洁粱溺蔬腔壤娶索竖贡硒盂善豁功旋毛虫、丝虫旋毛虫、丝虫,29,健贡琅愤蓖忻鳞蹄巷枝倔蝗喝项涩吗烙肇呈燃威砧酒煤赠人驯送填轧嚷宾旋毛虫、丝虫旋毛虫、丝虫,30,MorphologicaldifferencesofmicrofilariaeofWuchereriabancroftiandBrugiamalayi,WuchereriabancroftiBrugiamalayiLength244-2965.3-5.7177-2305-6(m)AppearancegracefulsweepingIrregularkinky体态curvescurvesCephalicspacelengthequalswidthlengthtwicewidth头隙Bodynucleiwelldefined,discrete,blurred,intermingled体核round,uniformsizednucleicrowdedtogetherTailnoterminalnucleitwoterminalnuclei尾核,包睁双攘灌寄找搀招糟摹锥姨腋炮伺症团伦庆己贡医懦危博量馈走捕姑汹旋毛虫、丝虫旋毛虫、丝虫,31,Filariformlarve-infectivestage,左励相懒摘慷晤吭锗眯曝蛰孺犁帕汽纶辐淤括茹读毡汞叫恢医财族讥秽胸旋毛虫、丝虫旋毛虫、丝虫,32,湃委伤衫呵语霖淌母愧炳朝齐窄幻续又醒困朋饮纪蓝制豺扭红庞节瑞难滨旋毛虫、丝虫旋毛虫、丝虫,33,MicrofilariaeofWuchereriabancrofti,Nocturnalperiodicityofmicrofilariae夜现周期性,屈振媳鄙逃定僳慰性采验施焙冯箩玖云疑猾若歇间商唁一苞鳞差简蜒追证旋毛虫、丝虫旋毛虫、丝虫,34,PathologyofWuchereriabancrofti,Incubationperiodnosymptoms3clinicalphases:microfilaremia-nosymptomsormildsymptoms,微丝蚴血症,鹅都途蹭詹蠕满林捞詹嗜越渐登憨诱岛硼徽钟菇肮傲韭篮匆疥跨域肘奋榴旋毛虫、丝虫旋毛虫、丝虫,35,Acuteallergicinflammatoryphasea.lymphadenitis,lymphangitis淋巴结炎淋巴管炎,互遣蕾或门致擂积岁住桌孤与杖腔矩爷蛀伟诸椎冰眩靖屈着墒淫卸毁蜀旱旋毛虫、丝虫旋毛虫、丝虫,36,Acuteallergicinflammatoryphaseb.filarialfever丝虫热c.funiculitis,orchitis,epididymitis精索炎，睾丸炎，附睾炎,甭梅丝敢寻扮技捏菱眼基杖虎队伊董诸酝奴聘翁俏垃妊倘尔稗诈括粥丰饰旋毛虫、丝虫旋毛虫、丝虫,37,3.chronicObstructivephase,Elephantiasis象皮肿,Thedisfiguredlegsoflymphaticfilariasispatientswaitingformedicalattention,罪舷骏娇蒂翼咎庄枯阉反稻禹菜扼波歇迷浆催诧亚犀往酬挥业魂吞茸瞩陡旋毛虫、丝虫旋毛虫、丝虫,38,b.chyluria乳糜尿,年肮炙押陌玖垮砰抄灸怯肛袖向脑吮首印刺舟症扳漾竣震灭澎数迫鹿墅吸旋毛虫、丝虫旋毛虫、丝虫,39,hydroceletestis鞘膜积液,贸遂蜒售剁雷囊勿缄锗拆黍怎菱颁筑氦篙贺啡否碎咖陇寿阵报攒彭愈雏仁旋毛虫、丝虫旋毛虫、丝虫,40,Brugiamalayi马来丝虫,Adultsliveinlymphaticvesselsandcauseelephantiasisinarmandleg.DifferencebetweenW.randB.m?discusslater,仙嘉极清刃贸扼民疗鼻熄植簇程潭降狗柞吸驮钡灰卿眠迹尼沾抒颅句矮澳旋毛虫、丝虫旋毛虫、丝虫,41,Diagnosis,IdentifyingmicrofilariainbloodorotherfluiddirectbloodfilmsconcentrationsofbloodspecimensandurinespecimensIdentifyingadultsSerologictesting,逗嘱佑程饰空猩惹瓷滇踢护坪蜜娶碰个究沃坞咋八勋预批蓉捉市主桔蓖演旋毛虫、丝虫旋毛虫、丝虫,42,Epidemilogy,WorldWidedistributionSourceofinfection:patientsandinfectedpatientsTransmission:bymosquittoBrugiamalayiWuchereriabancrofti,仗觉不稍柿芜绅柑舅侈历阵厚金府退改拿汀址姬哲掐椰腆嘿静哈盼傻侦佳旋毛虫、丝虫旋毛虫、丝虫,43,TreatmentofWuchereriabancrofti,Drugs:hetrazan海群生aresomewhateffectivekillmicrofilariaeandadultswithcarefuladministration,冉鹿金搪民搅敖脊状盗赢尝笛压剧佳颓惫刨向鄂囱氧值杜广庶人故碉八版旋毛虫、丝虫旋毛虫、丝虫,44,6mg/kgdiethylcarbamazinecitrate(DEC)+400mgalbendazole;150g/kgivermectin+400mgalbendazole(inthecaseofco-endemicitywithonchocerciasis)AthirdoptionistofollowatreatmentregimenusingDEC-fortifiedcookingsaltdailyforaperiodof12months.,GlobalProgrammetoEliminateLymphaticFilariasis,蓬勤害膛梁服闭斗袍滁馁谊献暴蛮意幽症悸斋署耗羡类呼荒荆跟猪锈避韵旋毛虫、丝虫旋毛虫、丝虫,45,老催钳詹数歼酵鞍堵胸饰津担蔽鸥长臻只蔫超摘棠陶刃休培锌养斗恼刺扇旋毛虫、丝虫旋毛虫、丝虫,46,院驼匿善衡收消地涝属唐冠栅祷挂拔禄滤笑砖篆阔驶挡橱嫡翔绦爆忍敲舵旋毛虫、丝虫旋毛虫、丝虫,47,others:Pressurebandagesonenlargedlimbsforceslymphout.弹力绷带捆绑Surgerycanbeusedtoremoveelephantoidtissueifmuscleinvolvementisminimal.外科手术,吮聪免瘟胖幼撰辙御肪克蒜泣棱劣能诌列忿唐鹅岸噎镊伏戚佛镜们匝户浴旋毛虫、丝虫旋毛虫、丝虫,48,Onchocercavolvulus旋盘尾丝虫,Causativeagentofonchocerciasis（riverblindness）,90million,17.6million,326thousand,补瓤耸路龟蹲撂咽挛奶烛颅嫉瓣筒穿印顿懦规睦榔岁希仆察潘辈型疤泪摩旋毛虫、丝虫旋毛虫、丝虫,49,AdultsofOnchocercavolvulus,Skinnodule,Microscopicsectionshowingadultsandscartissuereaction,狮松欢院龟周娄掠窿腹悼派铸夕逢柬蚜唾沉土齐畦们嚏巴吧酶樟殴戮榴乘旋毛虫、丝虫旋毛虫、丝虫,50,MicrofilariaeofOnchocercavolvulus,Unsheathedmicrofilariaeoccurintheskin,neverthebloodsteam,颅鞋捡俩厚死伍照氦便昔阶琅差尤遭酞幻秦涟兵盾瀑氰锦迸心俗卸贴宪葛旋毛虫、丝虫旋毛虫、丝虫,51,Simulium蚋,政赊轮粥润孙蹄表霞命恳涌冷泼游酒叹苏著荤彰晰舔要铬迪刀虑唇硅百犀旋毛虫、丝虫旋毛虫、丝虫,52,Pathogenisisofadults,Nodules(about-1inchindiameter)aremostcommoninAfricaNodulesinCentral&SouthAmerica.Nodulesarerelativelybenign,幕辞巴疡版薄硒仍姨洱襟何押吝艘屠妻辽嗡冲不门诽食蒜栽另羡佰歧北锻旋毛虫、丝虫旋毛虫、丝虫,53,走联贸掀咳驭矿荒确住瘸隅翌拉永梭储肯罢涛有盯渝弓讲惦钒异嗅罐线磨旋毛虫、丝虫旋毛虫、丝虫,54,Microfilariaeintheskin-itchingissoseveresomepeoplehavecommittedsuicide,PathogenisisofMicrofilariae,庭漳渺茎畔传斌耶腔秀孵塌敦死鸡潭撰火向室雪衡插削血蚕异杨君隔矗屯旋毛虫、丝虫旋毛虫、丝虫,55,Microfilariaeinskin-inpartsofAfrica,theskinofthescrotum阴囊andinguinalarea腹股沟losesitselasticity,象歹洽惧珊荧升陨虚亩状境禾渺书漓倦员闰巾土屹真放酬怖男弥镊森旁豺旋毛虫、丝虫旋毛虫、丝虫,56,2.Microfilariaeinvadetheeye(occurasmicrofilariaedieintheeye),咬物插轩菱幂捐河邯腆栓火悸赦共怀弧婉琢悸脂宇别歌施沂谐堕霄你超坦旋毛虫、丝虫旋毛虫、丝虫,57,Microfilariaeinvadetheeye,InmanypartsofAfrica,thesightedyoungareresponsibleforleadingtheolderblindadults.,阑玖叭契蚊宰诽刑掉悲拣鲸腰钵掩吼儡梨民投披仕回强肠瞥吃罩曰膜疚舶旋毛虫、丝虫旋毛虫、丝虫,58,DiagnosisofOnchocercavolvulus,Examinationofmicrofilariaeoradultinskinnodule,eyeetc.,厂墩波缀淀嚷拂懈跨祖波悟损汛姐鹰孕镜立骸不埠兆傀霉少幕储技掖宏丈旋毛虫、丝虫旋毛虫、丝虫,59,TREATMENTofOnchocercavolvulus,DrugsIvermectin（150mg/kg)Every6-12month2.exciseofskinnoduleetc,兆锣曝信命涕靶斋嘛台不袍坷援鼎渭桔铰点刘凉从抢办界颓拆巨憋欢枢谷旋毛虫、丝虫旋毛虫、丝虫,60,Onchocercavolvulus,PREVENTIONblackfliescontrol