传染病学英文版课件：LEPTOSPIROSIS

LEPTOSPIROSISDEFINITION1.Leptospirosisisakindofzoonoticinfectiousdiseasecausedbypathogenicleptospires;2.ratsandswinearecardinalsourceofinfection;3.thediseaseoftenoccursinsummerandfall;

DEFINITION

4.clinicalfeatures:threesymptoms,threesigns,internalorgandamage,seguelaeofeyesandnervesystem5.treatment:penicillin.

ETIOLOGY1.pathogen:pathogenicleptospira2.featuresofleptospia:helicoidwithhook,length6~20um,G-

darkfieldmicroscope;inkorthof’smedia;

ETIOLOGY

severalmonthsinwaterandmoistsoil(PH7.0~7.5)3.Classification:

23serogroupsandmorethen200serotypesintheworld;19serogroupand74serotypesinchina.

icterohemorrhagicgroup,pomonagroup1.Sourceofinfection:rat:apodemusagrarius,ricefieldtype;pigs:floodorraintype;

patientEPIDEMIOLOGY

EPIDEMIOLOGY2.Routesoftransmission:(1)waterborne(indirectcontacttransmission):byskin,mucosa,whenskinisinjured.(2)directcontacttransmission:(3)foodborne3.Susceptibilityofpopulation:

EPIDEMIOLOGY4.Epidemiologicfeatures:(1)season:summerandfall;(2)nosogenicage:youngandmiddleage,children(3)occupation:farmer,slaughter,fisher,veterinarian.

EPIDEMIOLOGY

4.Epidemiologicfeatures:(4)epidemictype:ricefieldtypefloodtyperaintypePATHOGENESISleptospiraskin,mucosaInitialstageleptospiremiatoxicsymptoms(1~3days)threesymptoms:fever,myalgia,fatigue;threesigns:conjunctivalsuffussion;

muscletenderness;enlargementoflymphonodes;

PATHOGENESISseveretoxicsymptomslesionoforgans:influenzaformpneumorrhagicformmiddlestageicterohemorrhagicform(3~10d)meningoencephalitisrenalfailureform.

PATHOGENESIS

immunopathologicalreaction

afterfever;sequelaeofeyes;reactivemeningitis;cerebroarteritisobliterans.

convalescentstagePATHOLOGY1.basicpathologicalchangeisinfective,toxicinjuredofsystemiccapillaries;2.severe:lung,liver,kidneys,brain.exudation,hemorrhage,edemaornecrosis.

CLINICALMANIFESTATIONS

Incubationperiod:2~28daysusually7~13days;1.Influenza-typhoidtype:5~10daysthreesymptoms:fever,myalgiaandfatigue.threesigns:conjunctivalsuffusion,

CLINICALMANIFESTATIONS

threesigns:conjunctivalsuffusion,tendernessofgastrocnemiusmuscle;enlargementandtendernessofsuperficiallymphnodes.Inguinalandaxillarylymphodes.

CLINICALMANIFESTATIONS

2.pneumorrhagiaform:

1).threesymptomsandthreesigns2).pneumorrhagiasymptoms(3~4d)(1).mildpneumorrhagiatypecough,expectorationwithblood.afewmoistrales.X-rayofchest:scatteringspottyandsmallfasciolashadowdyspnea,palpitaton,aspharyxia,rales.

CLINICALMANIFESTATIONS

2.pneumorrhagiaform:

(2)diffusepneumorrhagiatypeshortbreathing,palpitation,dysphoria,

massivehemoptysis,asphyxia,cyanosis,

alotofmoist

rales.X-ray:extensivefasciolashadow

.

CLINICALMANIFESTATIONS3.Icterohemorrhagictype:(Weil,sdisease)

1).threesymptomsandthreesigns2).jaundice,hemorrage,renalinjury(4~5d)liverinjury:anorexia,vomiting,jaundice,abnormalliverfunction.CLINICALMANIFESTATIONS3.Icterohemorrhagictype:(Weil,sdisease)hemorrhage:petechiae,ecchymoses,hemoptysis,hematemesisetc.renalinjury:proteinuria,RBC,WBC,cast,oliguria,azotemia,uremia.CLINICALMANIFESTATIONS4.renalfailuretype:

oliguria,azoteinia,uremia.5.meningoencephalitistype:

1).threesymptomsandthreesigns2).3~4dayslater,meningitis,encephalitis.

headache,vomiting,meningealirritation,

lethargy,coma,paralysisorconvulsion.CLINICALMANIFESTATIONS

CSFisabnormal.pressureincreasepleocytosis<500×106/Lproteinisnormalorelevatedslightly.glucoseandchlorideisnormal.leptospiraisolation:positive.

SEQUELAE

1.afterfever:1~5daysafterdefervascence2.sequelaeofeyes:1week~1month

iridocycyclitis,choroiditis,uveitis3.reactivemeningitis4.cerebroarteritisobliterans:2w~2mhemiplegiaaphasiaCLINICALMANIFESTATIONSLABORATORYFINDINGS:1.routineexamination:

1).bloodroutineexamination:WBCisincreasedslightly;2).urineroutineexamination:protein(2/3)2.serologicalexamination:

1).microscopicagglutinationtest(MAT)detectantibody>1:400

LABORATORYFINDINGS:

2).ELISA:serumandCSFIgMantibody3.pathogenictest

1).bloodculture:2).PCR:DNA

DIAGNOSIS1.epidemiologicdata:1).epidemicarea;2).epidemicseason;3).ahistoryofcontactwithcontaminatedwater;2.clinicalmanifestations:3.Labfindings:DIFFERENTIALDIAGNOS