vasculitis血管炎

1、RICKETTSIAORIENTIAEHRLICHIA ANAPLASMACOXIELLABARTONELLAGeneral introductionnGram-negative, obligate intracellular coccobacilli bacteria that infect mammaols and arthropodsnRickettsiae are transmitted in the arthropods,which serves as both vector and reserviornBoth DNA and RNAnIs sensitive to antibio

2、tic.Category of rickettsianGenus Rickettsia, Coxiella ,Orientia,Ehrlichia BartonellanSpecies Rickettsia prowazekii (epidemic typhus), Rickettsia typhi (endemic typhus), Rickettsia rickettsii (spotted fever), Rochalimaea quintana (trench fever), Coxiella burnetii (Q fever) Bilogical featuresnVariable

3、 shape, coccobacillinGram negativenMicrocapsule and slim layernCulture : in york sacs of embryonated eggsAntigenic structurenLPS Rickettsia tsutsugamushi Coxiella burnetii (Q fever) LPS smooth LPS rough Weil-Felix reacrionnSurface protein(SPA)TransmissionnTyphus, spotted fever and trench fever are t

4、ransmitted via arthropod vectors;nQ fever is acquired via inhalation or ingestion of contaminated milk or food. PathogenesisnVirulence factors: endotoxin, phospholipase A, and slime layernSites: vascular system producing vasculitis血管炎nCharacteristic triad of symptoms: fever, headache and rash (no ra

5、sh with Q fever). Rickettsia prowazekii普氏立克次体nepidemic typhusnaverage incubation periods (days):8nthe lousenRespiratory tract and conjunctivanLatent period: 2 weeksnAbrupt onset,fever,chills,headache, myalgia,arthralgiaReplication cycle of Rickettsia and Orientia Rickettsia typhi地方性斑疹伤寒立克次体nendemic

6、typhusn7-14 daysnMice nthe louse&fleanMouth,nose and conjunctivanGradual onset,fever,headache,myalgia, coughRickettsia tsutsugamushi恙虫病立克次体nTsutsugamushi disease(scrub typhus)nMice ntsutsugamushinBlack eachar焦痂Coxiella burnetti贝纳柯斯体贝纳柯斯体nQ fevernCow and sheepnticknHigh resistanceabrupt onset ,fe

7、ver,headache,chills,myalgia,granulomatous hepatitischronic diaease with subacute onset ,endocarditis,hepatic dysfunctionReplication of C. burnetii Generalized Life Cycle of Dermacentor variabilis and Dermacentor andersoni Ticks Bartonella henselae汉赛巴通体汉赛巴通体nCSD (cat scratch disease)nCat and dognConj

8、unctiva inflammation and lymph node swellEhrlichia埃里希体属nEhrlichia chaffeensis: human monocytotropic ehrlichiosisnEhrlichia sennetsu : human granulocyto tropic ehrlichiosisReplication of Ehrlichia埃里希体Proposed life cycle for the agent of Human Granulocytic Ehrlichiosis埃里希体病DiagnosisnThe use of immunof

9、luorescent antibodies to examine a biopsy can be diagnostic. nThe organism can be inoculated into tissue culture and grown over 4-7 days but this is very hazardous to personnel. nThe Weil-Felix test looks for the production of serum antibody that is reactive against Proteus OX19, OX2 or OXK antigens but it is not always reliable. ControlnSanitary: Arthrop