四体和真菌March精要.pptVIP

四体与真菌 支原体 Mycoplasma 立克次体 rickettsia 衣原体 chlamydia 螺旋体 spirochetes 真菌 fungi：真核细胞型微生物 * 微生物学检查法 白假丝酵母菌（俗称念珠菌） * 白假丝酵母菌菌体圆形或卵圆形，革兰染色阳性，大小不等，着色不均匀。 白假丝酵母菌形成假菌丝和厚膜孢子，有助鉴别。 * 白假丝酵母菌是条件致病菌，存在于人的皮肤、口腔、上呼吸道、阴道。 （1）入侵原因 机体抵抗力下降（AIDS） 大量、长期使用抗菌药物，激素和免疫抑制剂。 （2）入侵部位 皮肤粘膜感染：以鹅口疮、阴道炎最多见。 内脏感染：有肺炎、肠胃炎、心内膜炎等，偶而也可发生败血症。 中枢神经感染：脑膜炎、脑炎。 * 口腔念珠菌病是艾滋病患者最先出现的继发性感染。 新生隐球菌Cryptococcus neoformans 圆形，厚荚膜。  * 致病性 * 传染源：新生隐球菌在鸽子粪便中大量存在，人由呼吸道吸入而感染。 艾滋病、血液系统恶性肿瘤和应用皮质类固醇治疗的病人对隐球菌高度易感。 原发感染常发生在肺部，患者仅有流感样症状。在免疫功能低下时，引起支气管肺炎，呈暴发型感染并迅速死亡。部分患者发生血行播散，引起慢性脑膜炎，病程持续时间很长。 produce fried egg colonies on agar plates. Due to the slow growth of mycoplasmas, the colonies may take up to 3 weeks to develop and are usually very small Major antigenic determinants are glycolipids and proteins, some cross reaction with human tissues. * 病人血清与人O型红细胞混合，4度过夜。因支原体感染，血清中产生冷凝集素IgM（红细胞膜抗原的抗体），在4度，而非37度时，可与O型人红细胞结合，引起红细胞凝集。 * Since mycoplasmas lack a cell wall, the penicillins and cephalosporins are ineffective. The antibiotics of choice are tetracycline (adults only) and erythromycin Atypical pneumonia resolves spontaneously. Prevention is a problem due to the long duration of the disease. It is problematic to isolate patients to avoid close contact for a long period of time. No vaccines are currently available. * * Epidemic typhus is characterized by sudden onset of fever, chills, headache, myalgia, and arthralgia, after an average incubation period of 8 days. Approximately 7 days later a rash develops in most patients. The rash is maculopapular but can be petechial or hemorrhagic. In contrast to the rash seen with Rocky Mountain spotted fever, the rash in epidemic typhus develops on the trunk first and spreads to the extremities (centrifugal spread). Complications include: myocarditis, stupor, and delirium. The name typhus comes from the Greek for “smoke” underscoring the fact that stupor and delirium often complicate the disease. Recovery may take several months. The mortality rate va