伤寒英文课件

伤寒TypoidFeverTyphoidFever伤寒TypoidFever

DefinitionTyphoidfeverisanacuteinfectiousdiseaseofdigestivetractcausedbytyphoidbacillus.Placeoflesson

lymphaticsintheterminalileumPathologicalfeatureproliferationoflargemononuclearcellsderivedfromMPS伤寒TypoidFever

DefinitionClinicalfeature

sustainedfeverrelativeslowpulsetoxicsymptomsarose-colorrashsplenomegalyandhepatomegalyleukopeniaComplication

hemorrhage&perforation

伤寒TypoidFever

EtiologyCausativeorganism:TyphoidbacillusgenussalmonellagroupDPathogenicity:

endotoxinResistance:Stableinenvironment,sensitivetoheat,acid,commondisinfectants伤寒TypoidFever

EtiologyAntigenicity:Oantigen:lipopolysaccharidegroup-specialHantigen:protein,strain-specialViantigen:polysaccharide伤寒TypoidFeverEpidemiologySourceofinfectionPatient,Carrier,shedbacteriainfecesRouteoftransmissionFecal-oralroute:contaminatedfoodorwatercontagiousspreadspreadbyinsectSusceptibilityEpidemicfeaturessporadiccaseshighincidenceinfall&summer

伤寒TypoidFeverPathogenesis

BacillusStomachkilledbygastricacidincubationSmallintestinepenetratemucosaperiodRegionallymphaticsBloodstream-firstbacteremiainitialMPSinliver,spleen,bonemarrowBloodstream-secondbacteremiaendotoxinliverspleenregionallymphoticsClinicalsymptomsabscesinflammation伤寒TypoidFever

PathologyProliferationoflargemononuclearcell1stweek2nd3rdweek4thweekproliferationnecrosishealedemaulcerationnoscar伤寒TypoidFever

ClinicalmanifestationIncubationperiod:

7-23day(average10to14days)Typicaltyphoidfever:InitialperiodFastigiumDefervescenceConvalescence伤寒TypoidFeverClinicalmanifestationInitialperiodonset:insidious,gradualfever:Tstepwisefashionrisingnon-specialsymptoms:伤寒TypoidFeverClinicalmanifestationFastigiumsustainedfevertoxicsymptoms:

NSapathy,tinnitus,delirium,lethargy,comaDSanorexia,abdominalPain,diarrheaConstipationCSrelativeslowpulse,bradycardia,myocarditis伤寒TypoidFeverClinicalmanifestationFastigiumrose-coloredrash:

erythematousmaculesorpapulesoccuron6~13days

upperabdomenhepatomegalyandsplenomegaly伤寒TypoidFeverClinicalmanifestationDevervescenceConvalescence伤寒TypoidFeverClinicalmanifestationClinicaltype:Mildtypecommontypeprolongedtype,ambulatorytypefulminatetype伤寒TypoidFeverClinicalmanifestationRelapse:Itoccur1~3weekafterThasreachednormal.Theillnessfollowsasimilarpatterntotheprimaryattach.Bloodculturepositive.Recurrence:Itoccur3~4aftertheillness.Tbegintofall,thenriseagain.Bloodculturepositive.伤寒TypoidFeverComplicationsIntestinalhemorrhageIntestinalperforationToxichepatitisandmyocarditisPneumonia伤寒TypoidFeverLaboratoryFindingsBloodpicture:leukopeniaBacteriaculture:

bloodbonemorrowurineandstool伤寒TypoidFeverLaboratoryFindingsWidaltest:

agglutinationofserumreaction5Ag:“O”“H”,“HABC”titer:O>=1:80H>=1:160resultsanalysis:伤寒TypoidFeverDiagnosisEpidemiologicaldataClinicalmanifestationLaboratoryfindingsDefinitivediagnosis:bacteriaculturepositive伤寒TypoidFeverDifferentialDiagnosisTyphusrickettsisesmalariadisseminatedTB伤寒TypoidFeverTreatmentGeneraltherapyEtiologictherapyguinolone:firstchoicecephalosporins:2ndand3rdgenerationchloromycetin伤寒TypoidFeverPreventionControlofsourceofinfection:isolationInterruptionofrouteoftransmissionProt