《医学痢疾》PPT课件.ppt
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1、Bacillary Dysentery(shigellosis)Dept.Of Infectious DiseaseHuang FenHuang FenDefinitionAcute infectious disease of intestine caused by dysentery bacilli(genus shigella)Place of lesion:sigmoid&rectum Pathological feature:diffuse fibrious exudative inflammationDefinition Clinical manifestation:fever,ab
2、dominal pain,diarrhea,tenesmus,stool mixed with mucus blood,&pus.even companied with shock,toxic-encepholopthy.Etiology Causative organism:dysentery bacilli,genus shigella,gram-stained negative,non-motile short rod,Groups:4 serogroups&47 serotypesEtiologyS.dysenteriae:the most severeS.flexneri:the e
3、pidemic group and easily turn to chronicS.boydii:tropical and subonS.sonnei:the most mildEtiologyPathogenicity:-virulence endotoxin-exotoxin -invasiveness (attach-penetrate-multiply)Resistance:Strong,1-2week in fruits,vegetable and dirty soil,heat for 60 30 min EpidemiologySource of infection:patien
4、ts and carriersRoute of transmission:fecal-oral routeSuceptibility of population:immunity after infection is short and unsteady,no cross-immuneEpidemiology Epidemic features:season:summer&fallFlexneri,Soneii,dysenteryage:younger children Pathogenesis number of bacteria toxicity invasivenessattachmen
5、tpenetrationmultiplication immunity commonBacteriaintestinenormal intestinal florasIg A prevent attachingpenetrate mucusmultiply in epithelia cell&proper laminaendotoxinendogenous pyrogenfeverinflammationvessel contractionsuperficial mucosal necrosis and ulcerdiarrhea mixed with blood&pus,abdominal
6、painPathogenesis-toxicstrong-allergy to endotoxindemethyl-adrenaline DICmicro-circulatory failure shock,cerebral edema cerebral herniaPathology site of lesion:entire large bowel-sigmoid colon&rectum feature:acute:diffuse fibrinous exudative inflammation,Pathology hyperemia,edema,leukocyte infiltrati
7、on,superficial necrosis,ulcer.chronic:edema,polypoid hyperplasia,toxic:colon:hyperemia,edema,micro-capillary was invadedClinical manifestationIncubation period:1-2 day,(hours to 7 days)Acute dysenterycommon type mild typetoxic typeClinical manifestationcommon type:(typical type)acute onset,shiver,hi
8、gh feverabdominal pain(tenderness)diarrhea:stool mixed with mucus,blood&pustenesmus,1 week Clinical manifestationmild type:(atypical type)caused by S.sonneilow fever or no feverabdominal pain is mildstool mixed with mucus,without blood&pusdiagnosis by isolation of bacteria37dClinical manifestationto
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