麻疹(英文) - 幻灯片 1

1,麻疹MEASLES,重庆医科大学儿童医院DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,2,MEASLES,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Acute respiratory infectious disease caused by measles virus clinical feature: Fever, Cough, Runny nose, Conjunctivitis, Exanthem Specific sign: Kopliks Spots (a kind of enanthem ),3,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Classification: A RNA virus Genus: morbillivirus Family: paramyxoviridae Serotype: Only one Location: Nasopharyngeal secretions, Blood, Urine of patients,Pathogen,4,Pathogen,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,measles virus,5,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Infectious sources：Measles patients in acute stage Routes of transmission： Droplet sprayPopulation susceptibility：4.Epidemic features：,It is susceptible to all the people without infection or inoculation. The age of peak incidence was 6 months to 5 years old. The incidence of baby under 6m is lower.,6,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Routes of transmission,Epidemiology,7,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Epidemiology,Epidemic Features,8,9,10,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Epidemiology,Measles cases of in-patients in CHCUMS,11,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Pathophysiology,12,Respiratory epithelium regional lymph nodes,First viremia,Monocytes/Macrophage,Second viremia,Respiratory tract, conjunctiva, skin, etc,Virus elimination,Measles virus,Pathophysiology,13,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Pathology,14,Multinucleated giant cell(Warthin-finkeldey giant cells),Pathology Cytopathic change,PATHOGNOMONIC FOR MEASLES,= 100m, several nucleus inside the cell, formed by confluence of several virus infected reticuloendothelial cellsIn smears of the nasal mucosa in the prodromal stage,15,Multinucleated giant cell,Pathology Cytopathic change,PATHOGNOMONIC PRESENTATION FOR MEASLES,16,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Pathology,Respiratory tract Skin Kopliks spots,17,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Pathology skin,Red maculopapule,18,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Clinical manifestations,Typical manifestations Atypical manifestations,19,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,Incubation stage: 10-14daysProdromal stage: 3-4days,The prodrome develops on the day symptom begins (fever) and lasts until rash appear.,Fever Cough Coryza Conjunctivitis Kopliks spots,20,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,Prodromal stage: 3-4days,2.,Fever The magnitude and pattern of fever are variable in patients, from a low-grade to moderate fever or a sudden high fever may occur. Cough Coryza They are not specific symptoms for measles, which are identical to a common cold but catarrhal symptoms maybe more severe. Conjunctivitis May suggest measles before Kopliks spots. Kopliks Spots: Pathognomonic sign,21,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,typical facial appearance of measles in prodromal stage,22,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,23,Typical clinical manifestations,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Exanthem stage: 3-5days,Maculopapular rash:,Fever: temperature rises abruptly Catarrh: Other manifestations: enlarged lymph nodes, slight splenomegaly, gastrointestinal symptoms such as diarrhea and vomiting,24,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,25,Typical clinical manifestations,Maculopapular rash,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,26,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,appearing sequence of the rash,The rash usually starts on the upper lateral parts of the neck, behind the ears, along the hairline, and on the posterior parts of the cheek.,27,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,appearing sequence of the rash,It become increasingly maculopapular as the rash spreads rapidly over the entire face, neck, upper arms, and upper part of the chest within approximately the 24hr.,28,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,appearing sequence of the rash,29,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,Convalescent stage: 3-5 days,30,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Typical clinical manifestations,Branny desquamation and brownish discoloration (hyperpigmentation),Convalescent stage:,31,Summary of typical clinical features,414039383736,32,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Clinical manifestations,Atypical manifestations,33,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Clinical manifestations,Atypical manifestations,Mild measles Measles in adults Severe measles,Occurs in the patient with partial immunity,Occurs in the patients with immunocompromised,34,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Complications,35,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Complications,Pneumonia Subacute sclerosing panencephalitis (SSPE) & Encephalitis Laryngitis Exacerbation of tuberculosis Malnutrition and Vitamin A deficiency,the most frequent complication of measles (1) Primary pneumonia (2) Secondary pneumonia,36,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Lab studies,37,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Lab studies,38,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Diagnosis,39,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Diagnosis,Epidemiologic data Clinical data Laboratory data,40,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Diagnosis,Epidemiologic data,AgeSeasonHistory of contact with patientHistory of inoculation,41,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Diagnosis,Clinical data,Prodromal period,Convalescent period,Kopliks spots,Typical rash; correlation of rash and fever; catarrh,Branny desquamation and brownish discoloration,42,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Differential Diagnosis,Differential Diagnosis,43,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Differential diagnosis,Rubella Roseola infantum Enterovirus infection Exanthem caused by drugs,44,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Differential diagnosis,Rubella,45,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Differential diagnosis,Rubella (German Measles ),46,DIVISION OF INFECTIOUS DISEASE AND GASTROENTEROLOGY,Differential diagnosis,Measles Roseola infantum,The rash typically appears when the elevated temperature has abated, and can last for only a few h