传染病学课件疟疾英文课件

Malaria Definition vMalaria is a parasitosis caused by plasmodia. vIt is transmitted to human by the bite of mosquito. vClinical feature: cyclic chill, high fever & profuse sweating. In chronic illness, there are anemia & splenomegaly. Etiology vCausative organism: Plasmodia P. Vivax: tertian malaria P. Malariae: quartan malaria P. Falciparum: malignant malaria P. Ovale: tertian malaria vPathogenicity: merozoite, malarial pigment & products of metabolism Etiology vTachysporozoite vBradysporozoite vMerozoite vSporozoite vParasitemia Etiology vTow period: human - whole asexual reproduction mosquito - sexual parasitic stage vTwo host: human - intermediate host mosquito - final host vnotes: clinical symptoms: erythrocytic stage relapse: exerythrocytic stage infectivity: sporozoite Life cycle of the malaria parasite mosquito microgametocyte zygote oocyst sporozoite Blood stream tachysporozoite merozoite maturerupture Bradysporozoite Blood stream reenter phagocyte merozoite trophzoite shizont mature release merozoite gametocyte Erythrocytic phase Exoerythrocytic stage human Epidemiology vSource of infection Patient, parasite carrier vRoute of transmission female mosquito biting person blood transfusion vSusceptibility: universal susceptibility no-cross-immunity re-infection vEpidemic features: sporadic or endemic, tropic or subtropic Pathogenesis vMechanism of attack merozoite RBC rupture malaria pigment products of metabolism blood stream allergy vP. Faciparam: produce microvascular disease vmagnitude of the parasitemia & age of patient vno specific Ab or cell -mediated response Pathology vAnemia: P. Vivax - retiform RBC P. Malariae - mature RBC P. Falciparum - every RBC vProlifeation of mononuclear phagocyte hepatomegaly splenomegaly vCerebral edema & congestion Clinical manifestation Incubation period: quartan malaria: 24-30 day tertian malaria: 1315 day malignant malaria: 712 day Clinical manifestation Typical attack Chill: abrupt onset, shivering, pale face,cyanosis. Last 10 min or 12hr. High fever: T rise to 40oC with malaise, myalgia, thirsty. Last 26 Hr. Sweating: profuse sweating with restlessness regular 48 hr. or 72 hr. Cycle Clinical manifestation Sings anemia splenomegaly hepatomegaly, ALT elevate Clinical manifestation Perniciouse attack: cause by P. Falciparum cerebral malaria high fever, headache, vomiting, convulsion delirum, respiratory failure hyperpyrexia type T 420C, convulsion, delirium Relapse: early relapse - 6m Clinical manifestation Malaria caused by transfusion incubation period: 710 day no exerythrogenic phase, no relapse Complications vBlack- water- fever: cause:1/inadequate G-6-PD 2/The toxin release by malarial parasite 3/Allergic reaction to anti-malarial drugs feature:1/chill & fever 2/dark red or black urine 3/severe hemolytic anemia vAcute glomerulonephritis Laboratory Findings vBlood picture: decrease in RBC & Hb vblood film for parasite vserological examination ELISA for P. antigen DNA hybridization Diagnosis vEpidemiological data endemic zone blood transfusion vClinical manifestation vLaboratory findings vDiagnostic treatment: chloroqunine for 3 days Differential Diagnosis vTyphoid fever vSepticemia vLeptospirosis vEncephalitis B Treatment vAnti-malarial drugs Chloroquine-susceptable infection chloroquine : 1g /d, for 3 day, p.o. primaquine: for 8day, p.o. Chloroquine-resistant infection mefloguine: artemisinine Treatment vPernicious attack Chloroquine: 10mg/kg iv drop in 4 hr. Then 5mg/kg, iv drop in 2 hr. Quinin