版权说明:本文档由用户提供并上传,收益归属内容提供方,若内容存在侵权,请进行举报或认领
文档简介
1、Bacillary Dysentery (shigellosis) DefinitionlAcute infectious disease of intestine caused by dysentery bacilli(genus shigella)l Place of lesion: sigmoid & rectuml Pathological feature: l diffuse fibrious exudative l inflammationDefinitionl Clinical manifestation: l fever, abdominal pain, diarrhe
2、a, l tenesmus , stool mixed with l mucus blood, & pus. l even companied with shock, l toxic-encepholopthy.Etiologyl Causative organism: l dysentery bacilli, genus shigella, l gram-stained negative, l non-motile short rod, lGroups: 4 serogroups &47 serotypesEtiology S. dysenteriae: the most s
3、evere S. flexneri: the epidemic group and easily turn to chronic S. boydii: tropical and subon S. sonnei: the most mildEtiologylPathogenicity:l - virulencel endotoxin - exotoxinl - invasivenessl (attach-penetrate-multiply) lResistance: l Strong, 1-2week in fruits,vegetable l and dirty soil, heat for
4、 60 30 minl EpidemiologylSource of infection:l patients and carrierslRoute of transmission: l fecal-oral routelSuceptibility of population:l immunity after infection is short l and unsteady, no cross-immuneEpidemiologyl Epidemic features:lseason: summer & falllFlexneri, Soneii, dysenterylage: yo
5、unger childrenl Pathogenesisl number of bacterial toxicityl invasivenesslattachmentlpenetrationlmultiplicationl immunityl commonBacteriaintestinenormal intestinal florasIg A prevent attachingpenetrate mucusmultiply in epithelia cell & proper laminaendotoxinendogenous pyrogenfeverinflammationvess
6、el contractionsuperficial mucosal necrosis and ulcerdiarrhea mixed with blood & pus, abdominal painPathogenesis-toxicstrong - allergy to endotoxindemethyl-adrenaline DICmicro-circulatory failure shock, cerebral edema cerebral herniaPathologyl site of lesion:l entire large bowel-l sigmoid colon &
7、amp; rectuml feature:lacute: diffuse fibrinous l exudative inflammation, Pathology hyperemia, edema, leukocyte infiltration, superficial necrosis, ulcer.chronic: edema, polypoid hyperplasia,toxic: colon: hyperemia, edema, micro- capillary was invadedClinical manifestationlIncubation period: l 1-2 da
8、y, (hours to 7 days)lAcute dysenterylcommon type lmild typeltoxic typeClinical manifestationcommon type: (typical type)acute onset , shiver, high feverabdominal pain(tenderness)diarrhea: stool mixed with mucus, blood & pustenesmus, 1 week Clinical manifestationmild type: ( atypical type)caused b
9、y S. sonneilow fever or no feverabdominal pain is mildstool mixed with mucus, without blood & pusdiagnosis by isolation of bacteria37dClinical manifestationtoxic type: age: 2 to 7 yrs.abrupt onset, high fever, T 40oCdysphoria, lethargy, convulsion repeatedly,coma.circulatory & respiratory co
10、llapsediarrhea mild or absent at beginning Clinical manifestation shock form: septic shock brain form: dysphoria,lethargy,convulsion repeatedly,coma, brain hernia. respiratory failure mixed formClinical manifestationl chronic dysentery: 2 monthslchronic delayed type:chronic obscure typelacute attack
11、 typeClinical manifestationchronic delayed type: long-time and repeated abdominal pain, diarrhea, stool mixed with mucus, blood & pus. with fatigue, anemia, malnutrition. Clinical manifestationchronic obscure type: acute history in 1 year, no symptoms, stool culture positive or sigmoidscopyacute
12、 attack type: same as common acute dysenteryLaboratory Findingsl Blood picture: l WBC count increase,l (1020109/L) l neutrophils increasel Stool examination:lgross examination: stool mixed with l mucus, blood & pus. l Laboratory Findingsldirect microscopic examination: l WBC, RBC, pus cellslbact
13、eria culture:lPCR:DNAlSigmoidoscopy: l chronic patientsl shallow ulcerl scarl polypDifferential diagnosisl acute dysenterylamebic dysenteryl Entamoeba histolytical stool: reddish brown, like jaml flask-shaped ulcer, l amebic trophozoiteDifferential diagnosisuenteritis caused by E. Coli, u salmonella
14、, virus.uintussusception: u jam-like stools, u abdominal mass u absence of fever Differential diagnosisl chronic dysenterylrectal & colonic carcinoma:l no cure for long-term,l drop of weight of body lnon-specific ulcer colitis: l no cure for long-term,l culture of stool is negative, Differential
15、 diagnosis sigmoidoscopy: hemorrhage, ulcer, lead pipe.chronic schistosomiasis Japonica contact with the contaminated water hepatomegaly and splenomegaly founding the ovum of schistosomiasis Japonica Differential diagnosisl toxic dysentery lencephalitis B: highfever,convulsion,coma.l24hlcirculatory
16、failurelstool examinationlCSFlmeningeal irritationlSpecific IgMl TreatmentlCommon dysenterylToxic dysentery lgeneral treatmentlpathogenic treatment :l ofloxine l Ampicillin given by IVTreatmentusymptomatic treatment:ucontrol of high fever,convulsion:u subhibernation utreatment of shock: same as ECMutreatment of cerebral edema: u 20% mannitolTreatmentl chronic dysenterylgeneral therapy:l livel diet, nurishingl avoid overworkl exercise.uetiologic therapy: u sensitive antibiotics u used in turn or comb
温馨提示
- 1. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
- 2. 本站的文档不包含任何第三方提供的附件图纸等,如果需要附件,请联系上传者。文件的所有权益归上传用户所有。
- 3. 本站RAR压缩包中若带图纸,网页内容里面会有图纸预览,若没有图纸预览就没有图纸。
- 4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
- 5. 人人文库网仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对用户上传分享的文档内容本身不做任何修改或编辑,并不能对任何下载内容负责。
- 6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
- 7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。
最新文档
- 委托代理买房合同书2024年
- 2 1空气第二课时 九年级化学人教版上册
- 学校窗帘采购合同2024年
- 学校浴室合同2024年
- 苏教版初中物理重点知识点解析
- 买卖合同的法律规定2024年
- 人教版体育公开课课件
- 苏教版初三英语单词表记忆宝典
- 圆的周长北师大版教学研究
- 落花生环保手工制作说课稿
- 国潮风亮粉色中秋佳节花好月圆PPT模板课件
- 成语你演我猜课件
- 人教版六年级数学上册《比的应用》PPT课件
- 井巷工程施工组织设计范本
- GIS系统在220KV配电装置中的应用
- 光伏发电制氢项目可行性研究报告写作参考范文
- 劳动技术教育与语文学科整合教学设计
- 体育教师如何当好班主任
- 屋顶光伏发电项目施工方案
- 基于PLC控制全自动洗衣机毕业论文(设计)
- 运用EXCEL图表进行海森格纸绘制
评论
0/150
提交评论